Organization
PASSPORT TO BEHAVIORAL HEALTH LLC
Active
Other names
Passport to Behavioral Health LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE S COLES (ONWER)
(702) 479-8400
Entity
Organization
Contact information
Practice address
3162 W HAYDEN PEAK DR, QUEEN CREEK, AZ 85142-6092
(702) 479-8400
Mailing address
3162 W HAYDEN PEAK DR, QUEEN CREEK, AZ 85142-6092
(702) 479-8400
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
09/04/2019
Last updated
09/04/2019
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