Organization
DENOVA COLLABORATIVE HEALTH, LLC
Active
Other names
Denova Collaborative Health
Organization subpart
No
Provider details
NPI number
Authorized official
GRAHAM JOHNSON (CEO)
(602) 230-7373
Entity
Organization
Contact information
Practice address
2204 S DOBSON RD STE 201, MESA, AZ 85202-6457
(602) 230-7373
(602) 682-7455
Mailing address
3101 N CENTRAL AVE STE 500, PHOENIX, AZ 85012-2639
(602) 230-7373
(602) 682-7455
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
2084P0800X
Psychiatry Physician
—
—
208D00000X
General Practice Physician
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
AZ
Enumeration date
07/03/2017
Last updated
10/24/2023
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