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General NPI Number Information
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NPI Number | 1285324954
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Entity Type | Organization
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Legal Business Name | PACIFIC BEHAVIORAL CENTER INC
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Dates
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Enumeration Date | 05/08/2023
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Last Update Date | 05/08/2023
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Provider Practice Location Address
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Address Line | 6344 E BROWN RD
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City | MESA
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State | AZ
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Zip | 85205-4843
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Country | US
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Telephone | 702-626-7435
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Fax |
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Provider Business Mailing Address
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Address Line | 976 W ANGUS RD
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City | SAN TAN VALLEY
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State | AZ
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Zip | 85143-5105
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Country | US
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Telephone | 702-626-7453
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JANET M FALCONS
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Credential |
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Telephone | 702-626-7435
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QR0800X
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Taxonomy Name | Recovery Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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