| Psa Behavioral Health Agency | |
|
3271 E. Queen Creek Road Ste. 105, 110, 111 Gilbert AZ 85297 | |
| (480) 550-3193 | |
| (480) 550-3194 |
| Full Name | Psa Behavioral Health Agency |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3271 E. Queen Creek Road, Gilbert, Arizona |
| Authorized Official Name and Position | Kimberly Quiros (COO) |
| Authorized Official Contact | 6029951767 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Psa Behavioral Health Agency 2255 W Northern Ave Ste B100 Phoenix AZ 85021-4936 Ph: (602) 995-1767 | Psa Behavioral Health Agency 3271 E. Queen Creek Road Ste. 105, 110, 111 Gilbert AZ 85297 Ph: (480) 550-3193 |
| NPI Number | 1366094930 |
|---|---|
| Provider Enumeration Date | 07/12/2019 |
| Last Update Date | 04/03/2020 |
| Certification Date | 04/03/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366094930 | NPI | - | NPPES |
| CSLG9562 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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