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03D2279345 CLIA NUMBER - ECLIPSE PSYCHIATRY OUTPATIENT TREATMENT CENTER

Laboratory Demographics

CLIA Number: 03D2279345

Facility Name: ECLIPSE PSYCHIATRY OUTPATIENT TREATMENT CENTER

Facility Address:
2152 S VINEYARD STE 113
MESA, AZ
ZIP 85210
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Facility Phone Number: 623 282-2047

Facility Type: Practitioner Other

Certificate Type: Waiver
NPI Number: 1043888688

Taxonomy: 251S00000X - Community/Behavioral Health
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

CLIA Record

Field Name Field Value
CLIA Number 03D2279345
LAB Type Practitioner Other
Facility Name ECLIPSE PSYCHIATRY OUTPATIENT TREATMENT CENTER
Street 2152 S VINEYARD STE 113
City MESA
State AZ
ZIP 85210
Phone 623 282-2047
CertificateType 4
CertificateEffectiveDate 3/31/2023
CertificateExpirationDate 3/30/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024