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Organization
BENCHMARK VALLEY LLC
Active
Organization
BENCHMARK VALLEY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DELPHINE MARIE THOMPSON (CREDENTIALING SPECIALIST)
48088882123
Entity
Organization
Contact information
Practice address
5625 W EUCLID AVE, LAVEEN, AZ 85339-5247
(602) 980-6406
Mailing address
5625 W EUCLID AVE, LAVEEN, AZ 85339-5247
(602) 980-6406
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
BH4625
AZ
Other
Enumeration date
07/08/2015
Last updated
07/02/2020
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