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General NPI Number Information
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NPI Number | 1174305890
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Entity Type | Organization
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Legal Business Name | SEQUOIA BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 10/17/2023
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Last Update Date | 10/17/2023
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Provider Practice Location Address
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Address Line | 2152 S VINEYARD BLDG 5A
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City | MESA
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State | AZ
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Zip | 85210-6871
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Country | US
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Telephone | 928-460-0862
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Fax | 480-307-6911
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Provider Business Mailing Address
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Address Line | 2152 S VINEYARD BLDG 5A
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City | MESA
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State | AZ
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Zip | 85210-6871
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Country | US
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Telephone | 928-460-0862
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Fax | 480-307-6911
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Authorized Official
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Title or Position | CEO
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Name | SEAN PARSONS
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Credential | AASM, CPLC
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Telephone | 928-460-0862
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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