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NPI 1699484063

NPI 1699484063 : PASSION BEHAVIORAL HEALTH CENTER LLC : TEMPE, AZ

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General NPI Number Information
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    NPI Number           |    1699484063
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    Entity Type          |    Organization 
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    Legal Business Name  |    PASSION BEHAVIORAL HEALTH CENTER LLC 
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Dates
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    Enumeration Date     |    11/15/2022
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    Last Update Date     |    11/15/2022
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Provider Practice Location Address
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    Address Line         |    2428 E APACHE BLVD STE 115 
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    City                 |    TEMPE
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    State                |    AZ
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    Zip                  |    85288-4935
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    Country              |    US
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    Telephone            |    602-793-3603
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2428 E APACHE BLVD STE 115 
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    City                 |    TEMPE
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    State                |    AZ
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    Zip                  |    85288-4935
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    Country              |    US
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    Telephone            |    602-793-3603
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     SALEM  BEYENE 
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    Credential           |    
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    Telephone            |    602-793-3603
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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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