Ptl Behavioral Health, LLC
Community Based Residential Treatment Facility, Mental Illness in Mesa, AZ. Organization (NPI-2).
NPI number1003344367
StatusActive
Last updated in NPPESJul 21, 2022
Details
- NPI
- 1003344367
- Entity type
- Organization (NPI-2)
- Legal business name
- Ptl Behavioral Health, LLC
- Organization subpart
- No
- Enumeration date
- May 31, 2017
- Last updated
- Jul 21, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320800000X | Community Based Residential Treatment Facility, Mental Illness | – | – | Yes |
Practice location
10839 E Sonrisa AveMesa, AZ 85212-5126
Phone 480-485-6075 · Fax 480-485-6865
Mailing address
10839 E Sonrisa AveMesa, AZ 85212-5126
Phone 480-485-6075 · Fax 480-485-6865
Authorized official
Stephen Kissi Lauder
Administrator
4805169075
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