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Organization

BANNER BEHAVIORAL HEALTH HOSPITAL PRO FEE

Active
Parent organization
BANNER HEALTH
Organization subpart
Yes

Provider details

NPI number
Legal business name
BANNER HEALTH
Authorized official
DENNIS DAHLEN (SENIOR VP - FINANCE)
(602) 747-4000
Entity
Organization

Contact information

Practice address
7575 E EARLL DR, SCOTTSDALE, AZ 85251-6915
(480) 941-7500
Mailing address
1441 N 12TH ST, PHOENIX, AZ 85006-2837

Taxonomy

Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
261QM0855X
Adolescent and Children Mental Health Clinic/Center

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
894601
AZ
Enumeration date
10/09/2006
Last updated
10/15/2007
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