Individual
BERTOLD FORLEMU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
606 E PRESS RD, SAN TAN VALLEY, AZ 85140-5469
(480) 295-5878
Mailing address
5760 E THETIS DR, FLORENCE, AZ 85132-5549
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
02/01/2024
Last updated
02/01/2024
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