Organization
MINDVALLEY BEHAVIORAL HEALTH CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARTI VANDEMORE (ADMINISTRATOR)
(309) 989-7777
Entity
Organization
Contact information
Practice address
2737 E GREENWAY ROAD, SUITE 6, PHOENIX, AZ 85032-4391
(623) 404-4797
(480) 546-4297
Mailing address
2737 E GREENWAY ROAD, SUITE 6, PHOENIX, AZ 85032-4391
(623) 404-4797
(480) 546-4297
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
06/13/2023
Last updated
06/13/2023
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