| Lifespan Behavioral Health, Llc | |
|
1745 S Alma School Rd 172 Mesa AZ 85210-3009 | |
| (602) 324-4676 | |
| (480) 209-1063 |
| Full Name | Lifespan Behavioral Health, Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 1745 S Alma School Rd, Mesa, Arizona |
| Authorized Official Name and Position | Ronald Colby Miller (PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 6026223021 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifespan Behavioral Health, Llc 1745 S Alma School Rd 172 Mesa AZ 85210-3009 Ph: (602) 324-4676 | Lifespan Behavioral Health, Llc 1745 S Alma School Rd 172 Mesa AZ 85210-3009 Ph: (602) 324-4676 |
| NPI Number | 1033229281 |
|---|---|
| Provider Enumeration Date | 08/30/2006 |
| Last Update Date | 04/23/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033229281 | NPI | - | NPPES |
| 944654 | Medicaid | AZ | |
| 944654 | Other | AZ | MERCY CARE |
| 372456 | Other | AZ | MHN |
| 944654 | Other | AZ | EVERCARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 3676 (Arizona) | Primary |
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