Pinetop Behavioral Health LLC
Community/Behavioral Health in Phoenix, AZ. Organization (NPI-2).
NPI number1407586852
StatusActive
Last updated in NPPESJun 16, 2022
Details
- NPI
- 1407586852
- Entity type
- Organization (NPI-2)
- Legal business name
- Pinetop Behavioral Health LLC
- Organization subpart
- No
- Enumeration date
- Jun 16, 2022
- Certification date
- Jun 16, 2022
- Last updated
- Jun 16, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | – | – | Yes |
Practice location
9439 W Virginia AvePhoenix, AZ 85037-4433
Phone 207-409-6515
Mailing address
Po Box 2310Pinetop, AZ 85935-2310
Authorized official
Aimee Nyirakanyana
Owner
2074096515
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