Organization
BOSTON VILLA BEHAVIORAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYDIA BARTON (DIRECTOR)
(480) 939-9490
Entity
Organization
Contact information
Practice address
1420 W MISSOURI AVE, PHOENIX, AZ 85013-1919
(480) 939-9490
Mailing address
1718 S LONGMORE UNIT 72, MESA, AZ 85202-5770
(480) 939-9490
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/06/2020
Last updated
07/06/2020
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