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Organization
BEYOND BLUE HEALTH SERVICES LLC
Active
Organization
BEYOND BLUE HEALTH SERVICES LLC
Active
Other names
Beyond Blue Health Services LLC
Organization subpart
No
Provider details
NPI number
Authorized official
KEONA SCOTT (OWNER)
(702) 689-8658
Entity
Organization
Contact information
Practice address
7550 N 19TH AVE STE 104, PHOENIX, AZ 85021-7982
(602) 946-4120
Mailing address
7550 N 19TH AVE STE 104, PHOENIX, AZ 85021-7982
(602) 946-4120
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Enumeration date
04/07/2021
Last updated
05/04/2022
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