Organization
A DIFFERENT OUTLOOK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY MOORE (CEO)
(602) 566-2249
Entity
Organization
Contact information
Practice address
5646 E MAIN ST STE 5, MESA, AZ 85205-8800
(602) 675-9377
Mailing address
1923 E BROADWAY RD, PHOENIX, AZ 85040-2411
(602) 566-2249
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
08/23/2022
Last updated
08/23/2022
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