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Organization
DEVELOPMENTAL BH CONSULT
Active
Organization
DEVELOPMENTAL BH CONSULT
Active
Parent organization
PARC PLACE
Organization subpart
Yes
Provider details
NPI number
Legal business name
PARC PLACE
Authorized official
MICHAEL PUTOFF (CEO)
(480) 917-9301
Entity
Organization
Contact information
Practice address
2190 N GRACE BLVD, CHANDLER, AZ 85225-3416
(480) 917-9301
Mailing address
2190 N GRACE BLVD, CHANDLER, AZ 85225-3416
(480) 917-9301
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
357625
—
AZ
Enumeration date
04/09/2008
Last updated
04/09/2008
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