# ARIZONA CHILDRENS THERAPY CENTER LLC

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

## Provider details

- **NPI number:** 1023432465
- **Authorized official:** ROY EVANS (PARTNER)
- **Authorized official phone:** (480) 510-1599

## Contact information

- **Practice address:** 7545 W REDBIRD RD, PEORIA, AZ 85383-6253
- **Practice address phone:** (480) 510-1599
- **Practice address fax:** (623) 258-4136
- **Mailing address:** 8607 N 59TH AVE, SUITE C-6, GLENDALE, AZ 85302-5433

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | AZ | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | AP5146 | AZ | Yes |

## Other

- **Enumeration date:** 02/05/2014
- **Last updated:** 04/19/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 868036 | — | AZ |