Eagle Treatment Center LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

EAGLE TREATMENT CENTER LLC

Practice address

2920 N 24TH Ave Ste 230&240
Phoenix, AZ 85015-5947

Phone

(623) 800-9688

NPI assigned

May 20, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Geraldine Goodall

Title

Owner

Phone

(623) 800-9688

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1653004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666915200000",
    "number": "1255079273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 N 24TH AVE STE 230&240",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850155947",
            "telephone_number": "623-800-9688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 N 24TH AVE STE 230&240",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850155947",
            "telephone_number": "623-800-9688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE TREATMENT CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-20",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A",
        "authorized_official_last_name": "GOODALL",
        "authorized_official_first_name": "GERALDINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-800-9688"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.