Provider Demographics
NPI:1033717970
Name:SONORAN BEHAVIORAL HEALTH II, LLC
Entity Type:Organization
Organization Name:SONORAN BEHAVIORAL HEALTH II, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DOLORES
Authorized Official - Middle Name:A
Authorized Official - Last Name:PRECHEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-400-9292
Mailing Address - Street 1:10214 N 89TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85345
Mailing Address - Country:US
Mailing Address - Phone:623-248-9192
Mailing Address - Fax:623-289-7093
Practice Address - Street 1:10214 N 89TH AVE
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85345-6467
Practice Address - Country:US
Practice Address - Phone:623-248-9192
Practice Address - Fax:623-289-7093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness