Organization
A NEW LEAF, INC. - CENTRAL CAMPUS SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACIA DANIS (CREDENTIALING SPECIALIST)
(520) 591-5394
Entity
Organization
Contact information
Practice address
960 N STAPLEY DR, BUILDING 2 - 8 & 10, MESA, AZ 85203-5604
(480) 969-4024
(480) 969-0039
Mailing address
868 E UNIVERSITY DR, MESA, AZ 85203-8033
(480) 969-4024
(480) 969-0039
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
BH4297
AZ
Other
Enumeration date
07/29/2013
Last updated
07/31/2024
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