Provider Demographics
NPI:1710216817
Name:TREATMENT ON DEMAND
Entity Type:Organization
Organization Name:TREATMENT ON DEMAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:KENDRIC
Authorized Official - Middle Name:BURTON
Authorized Official - Last Name:SPEAGLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-612-4889
Mailing Address - Street 1:908 W CHANDLER BLVD STE B-4
Mailing Address - Street 2:SUITE 4
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-2549
Mailing Address - Country:US
Mailing Address - Phone:480-612-4889
Mailing Address - Fax:480-383-6996
Practice Address - Street 1:908 W CHANDLER BLVD STE B-4
Practice Address - Street 2:SUITE 4
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-2549
Practice Address - Country:US
Practice Address - Phone:480-612-4889
Practice Address - Fax:480-383-6996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-18
Last Update Date:2009-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH2988261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)