Organization
CIVARA BEHAVIORAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VITTELIAN FORBES PHARMD (OWNER)
(480) 329-9585
Entity
Organization
Contact information
Practice address
4010 W CACTUS RD, PHOENIX, AZ 85029-2905
(480) 329-9585
(602) 237-5211
Mailing address
7020 E MORELAND ST, SCOTTSDALE, AZ 85257-3318
(480) 329-9585
(602) 237-5211
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/01/2020
Last updated
11/18/2020
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