Provider Demographics
NPI:1144959750
Name:DIGNITY HEALTH BEHAVIORAL SERVICES
Entity type:Organization
Organization Name:DIGNITY HEALTH BEHAVIORAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LYDDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GETAWERU
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:480-773-8480
Mailing Address - Street 1:6911 S 13TH PL
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85042-5818
Mailing Address - Country:US
Mailing Address - Phone:480-773-8480
Mailing Address - Fax:480-546-3626
Practice Address - Street 1:6911 S 13TH PL
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85042-5818
Practice Address - Country:US
Practice Address - Phone:480-773-8480
Practice Address - Fax:480-546-3626
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DIGNITY HEALTH BEHAVIORAL SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness