Organization
HALLMARK BEHAVIORAL HEALTH @ LAGO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF TILLEY (MANGAGER)
(602) 695-4156
Entity
Organization
Contact information
Practice address
688 S LAGO DR, APACHE JUNCTION, AZ 85120-5123
(480) 625-1005
Mailing address
1550 E MCKELLIPS RD STE 109, MESA, AZ 85203-2753
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Enumeration date
05/19/2016
Last updated
02/06/2019
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