Organization
DIRECT CONNECT VENTURES LLC
Active
Organization
DIRECT CONNECT VENTURES LLC
Active
Other names
Desert Foothills Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IVORY KAIMARON PRICE (CEO)
(520) 371-3782
Entity
Organization
Contact information
Practice address
1760 E VILLA DR STE A, COTTONWOOD, AZ 86326-4679
(520) 371-3782
Mailing address
26 E BASELINE RD, SUITE 132, PHOENIX, AZ 85042-6951
(602) 362-5100
(928) 646-7153
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
OTC6593
AZ
251S00000X
Community/Behavioral Health Agency
—
—
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
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548741812
—
AZ
05
—
1649939539
—
AZ
Enumeration date
11/24/2015
Last updated
03/08/2022
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