Organization
THE RIVER SOURCE IOP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA STENZ BHT (BEHAVIORAL HEALTH INSURANCE COORDIN)
(450) 241-0170
Entity
Organization
Contact information
Practice address
128 W PEPPER PL, SUITE 126 & 128, MESA, AZ 85201-7317
(480) 241-0170
(480) 610-3823
Mailing address
128 W PEPPER PL, SUITE 126 & 128, MESA, AZ 85201-7317
(480) 241-0170
(480) 610-3823
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
08/04/2015
Last updated
08/04/2015
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