Provider Demographics
NPI:1083261945
Name:D&G BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:D&G BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:DANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZETTA
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:971-712-8899
Mailing Address - Street 1:3119 N 46TH DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85031-3705
Mailing Address - Country:US
Mailing Address - Phone:971-712-8899
Mailing Address - Fax:
Practice Address - Street 1:3119 N 46TH DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85031-3705
Practice Address - Country:US
Practice Address - Phone:971-712-8899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-24
Last Update Date:2019-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances