Organization
CHOLLA BEHAVIORAL HEALTH LLC
Active
Other names
Cholla Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERICHO CHEBULTZ (CEO)
(602) 686-5779
Entity
Organization
Contact information
Practice address
9201 N 25TH AVE STE 185, PHOENIX, AZ 85021-2717
(602) 686-5779
Mailing address
2020 W UNION HILLS DR UNIT 215, PHOENIX, AZ 85027-5816
(602) 686-5779
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
12/19/2022
Last updated
05/25/2023
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