Provider Demographics
NPI:1962168096
Name:MONTARE HOSPITALS LLC
Entity type:Organization
Organization Name:MONTARE HOSPITALS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:THI
Authorized Official - Middle Name:
Authorized Official - Last Name:HOANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-205-8232
Mailing Address - Street 1:203 S ORANGE DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-3010
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1501 E ORANGEWOOD AVE BLDG A
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-5130
Practice Address - Country:US
Practice Address - Phone:501-732-9505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MONTARE HOSPITALS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-11-12
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
No283Q00000XHospitalsPsychiatric Hospital
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility