Organization
BANNER BEHAVIORAL HEALTH - EAST VALLEY
Active
Parent organization
BANNER HEALTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
BANNER HEALTH
Authorized official
DENNIS DAHLEN (SR. VICE PRESIDENT FINANCE)
(602) 747-4000
Entity
Organization
Contact information
Practice address
1400 S DOBSON RD, MESA, AZ 85202-4707
(480) 464-4000
Mailing address
1441 N 12TH ST, PHOENIX, AZ 85006-2837
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
884008
—
AZ
Enumeration date
06/13/2006
Last updated
10/15/2007
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