Provider Demographics
NPI:1326287087
Name:TRIPLE R. BEHAVIORAL HEALTH, INC.
Entity Type:Organization
Organization Name:TRIPLE R. BEHAVIORAL HEALTH, INC.
Other - Org Name:TLP AMELIA
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOCHSTRASSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-995-7474
Mailing Address - Street 1:40 E MITCHELL DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2330
Mailing Address - Country:US
Mailing Address - Phone:602-995-7474
Mailing Address - Fax:602-973-2996
Practice Address - Street 1:937 E AMELIA AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-4743
Practice Address - Country:US
Practice Address - Phone:602-264-2559
Practice Address - Fax:602-264-2808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-19
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH-2242251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health