# AGAVE BEHAVIORAL HEALTH, LLC

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

## Provider details

- **NPI number:** 1174389878
- **Authorized official:** KELLY IRWIN NP (OWNER)
- **Authorized official phone:** (520) 603-8447

## Contact information

- **Practice address:** 36975 S ESTANCIA DR, MARANA, AZ 85658-8323
- **Practice address phone:** (520) 603-8447
- **Mailing address:** 1846 E INNOVATION PARK DR STE 100, ORO VALLEY, AZ 85755-1963
- **Mailing address phone:** (520) 603-8447

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 02/21/2024
- **Last updated:** 05/23/2024