Provider Demographics
NPI:1962796219
Name:CATHEDRAL HEALTH SERVICES
Entity type:Organization
Organization Name:CATHEDRAL HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:MATHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-254-7130
Mailing Address - Street 1:PO BOX 16252
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85011-6252
Mailing Address - Country:US
Mailing Address - Phone:602-254-7130
Mailing Address - Fax:602-445-6343
Practice Address - Street 1:6390 E THOMAS RD
Practice Address - Street 2:SUITE 218
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-7051
Practice Address - Country:US
Practice Address - Phone:602-254-7130
Practice Address - Fax:602-445-6343
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CATHEDRAL HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-06-03
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare