# CIVARA BEHAVIORAL HEALTH LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013524230
- **Authorized official:** VITTELIAN FORBES PHARMD (OWNER)
- **Authorized official phone:** (480) 329-9585

## Contact information

- **Practice address:** 4010 W CACTUS RD, PHOENIX, AZ 85029-2905
- **Practice address phone:** (480) 329-9585
- **Practice address fax:** (602) 237-5211
- **Mailing address:** 7020 E MORELAND ST, SCOTTSDALE, AZ 85257-3318
- **Mailing address phone:** (480) 329-9585
- **Mailing address fax:** (602) 237-5211

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 323P00000X | Psychiatric Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 10/01/2020
- **Last updated:** 11/18/2020