# A NEW LEAF, INC. - CENTRAL CAMPUS SERVICES

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

## Provider details

- **NPI number:** 1174965370
- **Authorized official:** GRACIA DANIS (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (520) 591-5394

## Contact information

- **Practice address:** 960 N STAPLEY DR, BUILDING 2 - 8 & 10, MESA, AZ 85203-5604
- **Practice address phone:** (480) 969-4024
- **Practice address fax:** (480) 969-0039
- **Mailing address:** 868 E UNIVERSITY DR, MESA, AZ 85203-8033
- **Mailing address phone:** (480) 969-4024
- **Mailing address fax:** (480) 969-0039

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | BH4297 | AZ | Yes |

## Other

- **Enumeration date:** 07/29/2013
- **Last updated:** 07/31/2024