Provider Demographics
NPI:1376795534
Name:ARIZONA ADDICTION TREATMENT PROGRAMS, INC
Entity Type:Organization
Organization Name:ARIZONA ADDICTION TREATMENT PROGRAMS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:R
Authorized Official - Last Name:GALLAGHER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LISAC
Authorized Official - Phone:480-644-9033
Mailing Address - Street 1:525 W SOUTHERN AVE STE 109
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210-5009
Mailing Address - Country:US
Mailing Address - Phone:480-644-9033
Mailing Address - Fax:480-644-8180
Practice Address - Street 1:525 W SOUTHERN AVE STE 109
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-5009
Practice Address - Country:US
Practice Address - Phone:480-644-9033
Practice Address - Fax:480-644-8180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH1819251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health