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General NPI Number Information
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NPI Number | 1649755893
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Entity Type | Organization
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Legal Business Name | SURPRISE BEHAVIORAL HOSPITAL LP
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Dates
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Enumeration Date | 10/03/2018
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Last Update Date | 04/14/2020
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Provider Practice Location Address
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Address Line | 16561 NORTH PARKVIEW PLACE
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City | SURPRISE
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State | AZ
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Zip | 85374
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Country | US
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Telephone | 602-615-1453
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Fax |
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Provider Business Mailing Address
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Address Line | 7611 E PASARO DR
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City | SCOTTSDALE
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State | AZ
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Zip | 85266-2774
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Country | US
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Telephone | 480-316-3708
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR / BOARD MEMBER
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Name | MR. BURTON TIMOTHY CARRIKER
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Credential | MS
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Telephone | 623-522-4525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number |
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License Number State |
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