Provider Demographics
NPI:1437115367
Name:LETT, ROHDE, & WALLING, PC
Entity Type:Organization
Organization Name:LETT, ROHDE, & WALLING, PC
Other - Org Name:ASAP ADOLESCENT SUBSTANCE ABUSE PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:WALLING
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:602-625-7889
Mailing Address - Street 1:1713 E LIBRA DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-3175
Mailing Address - Country:US
Mailing Address - Phone:602-434-0249
Mailing Address - Fax:
Practice Address - Street 1:2530 S ALMA SCHOOL RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-4016
Practice Address - Country:US
Practice Address - Phone:602-434-0249
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-20
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH-746261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder