Organization
BENCHMARK VALLEY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DELPHINE MARIE THOMPSON (CREDENTIALING SPECIALIST)
48088882123
Entity
Organization
Contact information
Practice address
5625 W EUCLID AVE, LAVEEN, AZ 85339-5247
(602) 980-6406
Mailing address
5625 W EUCLID AVE, LAVEEN, AZ 85339-5247
(602) 980-6406
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
BH4625
AZ
Other
Enumeration date
07/08/2015
Last updated
07/02/2020
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