Organization
MOONLIGHT TREATMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FELIX SAMUELS (MEMBER)
(770) 316-6495
Entity
Organization
Contact information
Practice address
341 E CAMELBACK RD, PHOENIX, AZ 85012-1613
(770) 316-6495
Mailing address
9209 W MIAMI ST, TOLLESON, AZ 85353-5597
(770) 316-6495
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
04/04/2023
Last updated
04/04/2023
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