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Organization

DENOVA COLLABORATIVE HEALTH, LLC

Active
Other names
Denova Collaborative Health, LLC, Bayless Integrated Healthcare
Organization subpart
No

Provider details

NPI number
Authorized official
GRAHAM JOHNSON (CEO)
(602) 230-7373
Entity
Organization

Contact information

Practice address
235 W WESTERN AVE, AVONDALE, AZ 85323-1848
(602) 230-7373
(623) 230-3086
Mailing address
3101 N CENTRAL AVE STE 550, PHOENIX, AZ 85012-2635
(602) 230-7373

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
OTC9070
AZ
208000000X
Pediatrics Physician
OTC9070
AZ
2084P0800X
Psychiatry Physician
OTC9070
AZ
208D00000X
General Practice Physician
OTC9070
AZ
261QM1300X
Multi-Specialty Clinic/Center
Primary
OTC9070
AZ

Other

Enumeration date
08/09/2018
Last updated
09/25/2024
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