Provider Demographics
NPI:1508625096
Name:MULTIPLEX BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:MULTIPLEX BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SHAFIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:KAKOOZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-338-1946
Mailing Address - Street 1:3425 E GRANT RD STE 200
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-2840
Mailing Address - Country:US
Mailing Address - Phone:800-338-1946
Mailing Address - Fax:
Practice Address - Street 1:3425 E GRANT RD STE 200
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-2840
Practice Address - Country:US
Practice Address - Phone:800-338-1946
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)