# MARK ALLEN FDT

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

## Provider details

- **NPI number:** 1720024839
- **Authorized official:** MRS. DONA MARIA HARMS BEHAVIORAL HEALTH TE (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (602) 973-3727

## Contact information

- **Practice address:** 2622 W STATE AVE, PHOENIX, AZ 85051
- **Practice address phone:** (602) 973-3727
- **Practice address fax:** (602) 841-2864
- **Mailing address:** 2622 W STATE AVE, PHOENIX, AZ 85051
- **Mailing address phone:** (602) 973-3727
- **Mailing address fax:** (602) 841-2864

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 323P00000X | Psychiatric Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 06/20/2006
- **Last updated:** 08/22/2020