Organization
MOUNTAIN TOP BEHAVIORAL HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OLUGBENGA A TEPEDE (CEO/PROGRAM DIRECTOR)
(623) 363-6408
Entity
Organization
Contact information
Practice address
3331 W FRAKTUR RD, PHOENIX, AZ 85041-4323
(602) 268-2462
(602) 276-5393
Mailing address
3331 W FRAKTUR RD, PHOENIX, AZ 85041-4323
(602) 268-2462
(602) 276-5393
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
BH 3443
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH 3443
ARIZONA DEPARTMENT OF HEALTH SERVICES
AZ
Enumeration date
09/30/2009
Last updated
09/30/2009
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