| Civara Behavioral Health Llc | |
|
4010 W Cactus Rd Phoenix AZ 85029-2905 | |
| (480) 329-9585 | |
| (602) 237-5211 |
| Full Name | Civara Behavioral Health Llc |
|---|---|
| Speciality | Psychiatric Residential Treatment Facility |
| Location | 4010 W Cactus Rd, Phoenix, Arizona |
| Authorized Official Name and Position | Vittelian Forbes (OWNER) |
| Authorized Official Contact | 4803299585 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Civara Behavioral Health Llc 7020 E Moreland St Scottsdale AZ 85257-3318 Ph: (480) 329-9585 | Civara Behavioral Health Llc 4010 W Cactus Rd Phoenix AZ 85029-2905 Ph: (480) 329-9585 |
| NPI Number | 1013524230 |
|---|---|
| Provider Enumeration Date | 10/01/2020 |
| Last Update Date | 11/18/2020 |
| Certification Date | 11/18/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013524230 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 323P00000X | Psychiatric Residential Treatment Facility | (* (Not Available)) | Primary |
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