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Organization
MEDICINE MAN INC
Active
Organization
MEDICINE MAN INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICAH HALE DO (PRESIDENT)
(623) 246-4900
Entity
Organization
Contact information
Practice address
9700 N 91ST ST STE A115, SCOTTSDALE, AZ 85258-5036
(623) 246-4900
Mailing address
9700 N 91ST ST STE A115, SCOTTSDALE, AZ 85258-5036
(623) 246-4900
(623) 288-1103
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
NULL
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
251S00000X
Community/Behavioral Health Agency
—
NULL
261QC1500X
Community Health Clinic/Center
—
NULL
261QM2500X
Medical Specialty Clinic/Center
Primary
—
NULL
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
NULL
261QU0200X
Urgent Care Clinic/Center
—
NULL
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
—
NULL
324500000X
Substance Abuse Rehabilitation Facility
—
NULL
333300000X
Emergency Response System Companies
—
NULL
343900000X
Non-emergency Medical Transport (VAN)
—
NULL
347C00000X
Private Vehicle
—
NULL
Other
Enumeration date
12/15/2022
Last updated
09/05/2026
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