Organization
DIRECT CONNECT VENTURES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IVORY KAIMARON PRICE (CEO)
(520) 371-3782
Entity
Organization
Contact information
Practice address
5010 E. WARNER RD., STE. 111, AHWATUKEE, AZ 85044-3354
(480) 245-6066
Mailing address
2320 E BASELINE RD STE 148-473, PHOENIX, AZ 85042-6951
(520) 371-3782
(866) 624-2580
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
AZ
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
385H00000X
Respite Care
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
Other
Enumeration date
07/02/2014
Last updated
07/29/2020
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