MEDICARE: DEHP LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	171M00000X	Case Manager/Care Coordinator
2	261QC1500X	Community Health Clinic/Center
3	261QH0100X	Health Service Clinic/Center
4	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
5	261QM0850X	Adult Mental Health Clinic/Center
6	261QP2300X	Primary Care Clinic/Center
7	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
8	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1063363950
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEHP LLC

Provider Business Mailing Address
First Line	:	3800 N CENTRAL AVE STE 1010
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85012-1918
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2437 N STONE AVE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85705-4528
Country	:	US
Telephone Number	:	602-566-7627
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JOSETTE D SULLINS
Credential	:
Telephone Number	:	602-566-7627

Provider Enumeration Date	:	02/05/2026
Last Update Date	:	02/05/2026

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