Healthcare Provider Details

I. General information

NPI: 1437571213
Provider Name (Legal Business Name): UBH OF PHOENIX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2014
Last Update Date: 06/10/2020
Certification Date: 06/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3550 E PINCHOT AVE
PHOENIX AZ
85018-7434
US

IV. Provider business mailing address

3550 E PINCHOT AVE
PHOENIX AZ
85018-7434
US

V. Phone/Fax

Practice location:
  • Phone: 602-957-4000
  • Fax: 602-368-2598
Mailing address:
  • Phone: 602-957-4000
  • Fax: 602-368-2598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STEVE FILTON
Title or Position: SR VP CFO
Credential:
Phone: 610-768-3300