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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