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Organization
A NEW LEAF, INC.
Active
Organization
A NEW LEAF, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN BECKSTEAD (DIRECTOR OF INFORMATICS)
(480) 848-6088
Entity
Organization
Contact information
Practice address
2254 W MAIN ST, MESA, AZ 85201-6847
(480) 969-4024
Mailing address
868 E UNIVERSITY DR, MESA, AZ 85203-8033
(480) 969-4024
(480) 969-0039
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
577747
—
AZ
01
—
OTC9432
ARIZONA DEPARTMENT OF HEALTH SERVICES
AZ
Enumeration date
03/19/2019
Last updated
01/24/2020
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