Healthcare Provider Details

I. General information

NPI: 1154954113
Provider Name (Legal Business Name): BABBITT BOWERS BEHAVIORAL HEALTH SERVICES. LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2020
Last Update Date: 09/24/2020
Certification Date: 09/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 N GILBERT RD
MESA AZ
85203-6629
US

IV. Provider business mailing address

605 N GILBERT RD
MESA AZ
85203-6629
US

V. Phone/Fax

Practice location:
  • Phone: 480-238-8721
  • Fax:
Mailing address:
  • Phone: 480-238-8721
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRISTY BABBITT
Title or Position: MEMBER
Credential:
Phone: 480-238-8721