Organization
ARIZONA BEHAVIORAL HOME HEALTH SERVICES LLC
Active
Organization
ARIZONA BEHAVIORAL HOME HEALTH SERVICES LLC
Active
Other names
Mentus Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DARYL CRAIG MILLAR (ADMINISTRATIVE DIRECTOR)
(602) 264-2770
Entity
Organization
Contact information
Practice address
4620 N 16TH ST, E-110, PHOENIX, AZ 85016-5121
(602) 264-2770
(866) 534-1701
Mailing address
4620 N 16TH ST, E-110, PHOENIX, AZ 85016-5121
(602) 264-2770
(866) 534-1701
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
3376
AZ
251S00000X
Community/Behavioral Health Agency
Primary
BH-3188
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
703307
—
AZ
01
—
BH-3188
OBHL LICENSE
AZ
Enumeration date
07/29/2009
Last updated
07/29/2009
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