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General NPI Number Information
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NPI Number | 1841986767
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Entity Type | Organization
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Legal Business Name | MORADA BEHAVIORAL HEALTH CENTER
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Dates
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Enumeration Date | 04/13/2023
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 405-B W. MAIN STREET
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City | PAYSON
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State | AZ
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Zip | 85541-8554
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Country | US
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Telephone | 602-456-1504
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Fax |
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Provider Business Mailing Address
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Address Line | 309 S STONE CREEK CIR
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City | PAYSON
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State | AZ
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Zip | 85541-6292
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Country | US
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Telephone | 602-456-1504
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | DR. CHRISTINA KELLEY
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Credential | DSW
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Telephone | 602-456-1504
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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