Healthcare Provider Details

I. General information

NPI: 1861855702
Provider Name (Legal Business Name): TOUCHSTONE BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2016
Last Update Date: 06/06/2023
Certification Date: 06/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12409 W INDIAN SCHOOL RD BLDG E
AVONDALE AZ
85392-9502
US

IV. Provider business mailing address

15820 N 35TH AVE STE 14
PHOENIX AZ
85053-7608
US

V. Phone/Fax

Practice location:
  • Phone: 602-732-4950
  • Fax: 602-732-5480
Mailing address:
  • Phone: 866-207-3882
  • Fax: 602-732-5480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateAZ

VIII. Authorized Official

Name: KIM EGAN
Title or Position: CHIEF QUALITY OFFICER
Credential: MAED, LPC
Phone: 623-692-7409