Organization
ESRD BEHAVIORAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LINH NGUYEN MD (CEO)
(623) 374-7774
Entity
Organization
Contact information
Practice address
14780 W MOUNTAIN VIEW BLVD STE 110, SURPRISE, AZ 85374-7280
(623) 374-7774
(855) 420-6361
Mailing address
14780 W MOUNTAIN VIEW BLVD STE 110, SURPRISE, AZ 85374-7280
(623) 374-7774
(855) 420-6361
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
35198
AZ
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
07/13/2018
Last updated
12/06/2018
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