Healthcare Provider Details

I. General information

NPI: 1356217095
Provider Name (Legal Business Name): DEHP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2025
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3336 N 32ND ST STE 111
PHOENIX AZ
85018-6241
US

IV. Provider business mailing address

3800 N CENTRAL AVE STE 1010
PHOENIX AZ
85012-1918
US

V. Phone/Fax

Practice location:
  • Phone: 623-931-1052
  • Fax:
Mailing address:
  • Phone: 602-566-7627
  • Fax: 602-566-7627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MEREDITH A MATICS
Title or Position: MEDICAL BILLER
Credential:
Phone: 714-292-2666