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NPI Code Detail

MEDICARE: CH MH SERVICES (AZ), LLC

MEDICARE: CH MH SERVICES (AZ), LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center
2261QM0850XAdult Mental Health Clinic/Center
3251S00000XCommunity/Behavioral Health Agency
43245S0500XChildren's Substance Abuse Rehabilitation Facility
5261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
6324500000XSubstance Abuse Rehabilitation Facility
7261QM0855XAdolescent and Children Mental Health Clinic/Center

General Provider Information

NPI Number : 1306442744
Entity Type Code : Organization
Provider Name (Legal Business Name) : CH MH SERVICES (AZ), LLC
Provider Business Mailing Address
First Line : 169 MADISON AVE STE 15011
Second Line :
City : NEW YORK
State : NY
Zip : 10016-5101
Country : US
Telephone Number : 406-361-3146
Fax Number : 406-794-0352
Provider Business Practice Location Address
First Line : 6991 E CAMELBACK RD STE D300
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85251-2492
Country : US
Telephone Number : 986-206-0414
Fax Number : 406-794-0395
Authorized Official
Title or Position : VP, RCM
Name : CHARIE BRYANT
Credential :
Telephone Number : 803-955-6655
Provider Enumeration Date : 12/10/2020
Last Update Date : 11/14/2025

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