Provider Demographics
NPI:1649755893
Name:SURPRISE BEHAVIORAL HOSPITAL LP
Entity Type:Organization
Organization Name:SURPRISE BEHAVIORAL HOSPITAL LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR / BOARD MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:BURTON
Authorized Official - Middle Name:TIMOTHY
Authorized Official - Last Name:CARRIKER
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:623-522-4525
Mailing Address - Street 1:7611 E PASARO DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85266-2774
Mailing Address - Country:US
Mailing Address - Phone:480-316-3708
Mailing Address - Fax:
Practice Address - Street 1:16561 NORTH PARKVIEW PLACE
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374
Practice Address - Country:US
Practice Address - Phone:602-615-1453
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-03
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital