Provider Demographics
NPI:1740397058
Name:RED MOUNTAIN BEHAVIORAL HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:RED MOUNTAIN BEHAVIORAL HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:RUANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-641-9552
Mailing Address - Street 1:890 W ELLIOT RD STE 103
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-5127
Mailing Address - Country:US
Mailing Address - Phone:480-641-9552
Mailing Address - Fax:480-981-0893
Practice Address - Street 1:6661 E HERMOSA VISTA DR
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85215-2207
Practice Address - Country:US
Practice Address - Phone:480-641-9552
Practice Address - Fax:480-981-0893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH-3633385HR2055X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child