1164711750 NPI number — SINGLETON HOUSING,LLC

Table of content: (NPI 1164711750)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164711750 NPI number — SINGLETON HOUSING,LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SINGLETON HOUSING,LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
REAL HEALTH OUTPATIENT CLINIC
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164711750
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/04/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8102 N 23RD AVE
Provider Second Line Business Mailing Address:
SUITE B
Provider Business Mailing Address City Name:
PHOENIX
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85021-4962
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
602-626-8150
Provider Business Mailing Address Fax Number:
602-626-8406

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8102 N 23RD AVE
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
PHOENIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85021-4962
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-626-8150
Provider Business Practice Location Address Fax Number:
602-626-8406
Provider Enumeration Date:
04/04/2011

Additional Information

Authorized Official

Authorized Official Last Name:
SINGLETON
Authorized Official First Name:
ELIZABETH
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMIN
Authorized Official Telephone Number:
602-626-8150

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X , with the licence number:  BH3830 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251K00000X , with the licence number: BH3830 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X , with the licence number: 3830 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 252Y00000X , with the licence number: BH3830 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 347C00000X , with the licence number: BH3830 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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