MULLIGAN'S MANOR INC. NPI 1427536770

NPI Information

NPI: 1427536770
Provider Name: MULLIGAN'S MANOR, INC.
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
4701 S LAKESHORE DR UNIT 1
TEMPE, AZ
ZIP 85282
Phone: (480) 831-8721
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MULLIGAN'S MANOR, INC. is a mental health counselor in Tempe, AZ. MULLIGAN'S MANOR, INC. NPI is 1427536770. The provider is registered as an organization entity type.

The provider's business location address is:

4701 S LAKESHORE DR UNIT 1
TEMPE, AZ
ZIP 85282-169
Phone: (480) 831-8721
Fax: (480) 272-8708

The provider's authorized official is Jennifer Samayoa Diaz .
The authorized official title is Executive Director and has the following contact phone number (480) 831-8727.

The enumeration date for this NPI number is 7/30/2018 and was last updated on 7/30/2018.

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 Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	261QC1500X	Clinic/Center	Community Health	No
2	261QM0855X	Clinic/Center	Adolescent and Children Mental Health	No
3	101YM0800X	Counselor	Mental Health	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	217581	MEDICAID	ARIZONA

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

NPI Synchronization or Removal

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