1514 BETHANY HOME MANAGEMENT, LLC
NPI: 1801369632
· PHOENIX, AZ 85015
· Case Management Agency
· NPI assigned 01/03/2019
$103K
Total Medicaid Paid
Provider Details
| Authorized Official | GUAJARDO, JAMES (MANAGER) |
| NPI Enumeration Date | 01/03/2019 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
75 |
$103K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H0018 |
Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem |
75 |
32 |
$103K |