Organization · Type 2 NPI

Phoenix Gospel Mission, Inc. dba Phoenix Rescue Mission

Community/Behavioral Health Agency · Phoenix, AZ

NPI number 1740876242 Active

Practice location

338 N 15th Ave
Phoenix, AZ 85007-2402

Call (602) 475-1695 Map

Mailing address

1540 W Van Buren St
Phoenix, AZ 85007-2414

Specialties and licenses

Taxonomy	Code	License
Community/Behavioral Health Agency Primary	251S00000X	None listed

Community/Behavioral Health Agency: A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day suppo…

5 other providers at this address

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NPI record

NPI: 1740876242
Entity type: Organization (Type 2)
Issued: Dec 18, 2020
Last updated: Oct 17, 2023
Status: Active

Other names

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Phoenix Rescue Mission · doing business as
Phoenix Rescue Mission · doing business as

Authorized official

Nathan Smith
Chief Program Officer
(602) 419-8194

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1740876242

Phoenix Gospel Mission, Inc. dba Phoenix Rescue Mission's National Provider Identifier is 1740876242, issued on Dec 18, 2020. The primary taxonomy on file is Community/Behavioral Health Agency (251S00000X), and the practice location is in Phoenix, AZ. The record was last updated on Oct 17, 2023.