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BROTHERHOOD OF THE BROKEN NPI 1356847008


NPI Information

NPI: 1356847008
Provider Name: BROTHERHOOD OF THE BROKEN

Doing Business As: RESTORED LIFE COUNSELING

Classification: Counselor - 101Y00000X
Entity Type: Organization
Address:
14050 N 83RD AVE STE 290
PEORIA, AZ
ZIP 85381
Phone: (623) 267-5849
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BROTHERHOOD OF THE BROKEN is a counselor in Peoria, AZ. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. BROTHERHOOD OF THE BROKEN NPI is 1356847008. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Restored Life Counseling.

The provider's business location address is:

14050 N 83RD AVE STE 290
PEORIA, AZ
ZIP 85381-650
Phone: (623) 267-5849
Fax: (360) 989-1140

The provider's authorized official is Daniel T Stephens .
The authorized official title is President and has the following contact phone number (623) 267-5849.

The enumeration date for this NPI number is 4/2/2018 and was last updated on 9/15/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101Y00000XCounselorYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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