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Contact Information

ESRD BEHAVIORAL HEALTH, LLC
14780 W MOUNTAIN VIEW BLVD STE 110
SURPRISE, AZ85374-7280
 Phone: 623-374-7774
 Fax: 855-420-6361
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
 

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for ESRD BEHAVIORAL HEALTH, LLC

NPI # 1306322391
LBN Legal business name ESRD BEHAVIORAL HEALTH, LLC
Authorized official LINH NGUYEN - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 07/13/2018
Last updated 12/06/2018 - About 7 years ago
Identifiers
AZ License # 35198
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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