| Passport To Behavioral Health Llc | |
|
3162 W Hayden Peak Dr Queen Creek AZ 85142-6092 | |
| (702) 479-8400 | |
| Not Available |
| Full Name | Passport To Behavioral Health Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 3162 W Hayden Peak Dr, Queen Creek, Arizona |
| Authorized Official Name and Position | Denise S Coles (ONWER) |
| Authorized Official Contact | 7024798400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Passport To Behavioral Health Llc 3162 W Hayden Peak Dr Queen Creek AZ 85142-6092 Ph: (702) 479-8400 | Passport To Behavioral Health Llc 3162 W Hayden Peak Dr Queen Creek AZ 85142-6092 Ph: (702) 479-8400 |
| NPI Number | 1982253894 |
|---|---|
| Provider Enumeration Date | 09/04/2019 |
| Last Update Date | 09/04/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982253894 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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