Organization
SHORELINE BEHAVIORAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SADE COLLINS (DIRECTOR)
(623) 213-5356
Entity
Organization
Contact information
Practice address
4514 W HASAN DR, LAVEEN, AZ 85339-1959
(623) 213-5356
Mailing address
1816 W MAGDALENA LN, PHOENIX, AZ 85041-7815
(623) 213-5356
(480) 383-6782
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
09/24/2019
Last updated
09/24/2019
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