National Provider Identifier Database

BANNER BEHAVIORAL HEALTH EAST VALLEY
Health Service


Contact Information

BANNER BEHAVIORAL HEALTH - EAST VALLEY
1400 S DOBSON RD
MESA, AZ85202-4707
Phone: 480-464-4000
Fax:
Website:
Specialty Taxonomy Code
* Health Service 261QH0100X

* Indicates primary specialty

NPI Profile & details for BANNER BEHAVIORAL HEALTH - EAST VALLEY

NPI Number 1447292214
Legal business name
LBN
BANNER BEHAVIORAL HEALTH - EAST VALLEY
Authorized official DENNIS DAHLEN - (SR. VICE PRESIDENT FINANCE)
Entity Organization
Organization subpart Yes
Enumeration date 06/13/2006
Last updated 10/15/2007 - About 19 years ago
Sole proprietor1 Not specified
Identifiers
  • AZ Medicaid: 884008

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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