Provider Demographics
NPI:1326745332
Name:THERAPY TRUST BEHAVIORAL HEALTH INC
Entity Type:Organization
Organization Name:THERAPY TRUST BEHAVIORAL HEALTH INC
Other - Org Name:THERAPY TRUST BEHAVIORAL HEALTH INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:STAFF USER
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-602-7429
Mailing Address - Street 1:4220 N 19TH AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-5106
Mailing Address - Country:US
Mailing Address - Phone:602-881-3569
Mailing Address - Fax:
Practice Address - Street 1:4220 N 19TH AVE STE 205
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-5106
Practice Address - Country:US
Practice Address - Phone:602-881-3569
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-09
Last Update Date:2023-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health