Provider Demographics
NPI:1326763731
Name:CAPE BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:CAPE BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:AUBREY
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:LAIRD
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:928-238-0156
Mailing Address - Street 1:6134 E MAIN ST STE 108
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85205-8962
Mailing Address - Country:US
Mailing Address - Phone:928-238-0156
Mailing Address - Fax:
Practice Address - Street 1:6134 E MAIN ST STE 108
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205-8962
Practice Address - Country:US
Practice Address - Phone:928-238-0156
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-07
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty