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General NPI Number Information
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NPI Number | 1861113185
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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 | 09/06/2022
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Last Update Date | 09/06/2022
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Provider Practice Location Address
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Address Line | 5525 S COYOTE CYN
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City | MESA
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State | AZ
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Zip | 85212-9149
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Country | US
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Telephone | 928-460-0862
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Fax |
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Provider Business Mailing Address
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Address Line | 9221 E BASELINE RD STE 109 #443
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City | MESA
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State | AZ
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Zip | 85209
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Country | US
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Telephone | 928-460-0862
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. SEAN C PARSONS
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Credential | AASM
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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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Taxonomy #2
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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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 | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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