Provider Demographics
NPI:1780005033
Name:EBH SOUTHWEST SERVICES, INC.
Entity Type:Organization
Organization Name:EBH SOUTHWEST SERVICES, INC.
Other - Org Name:PROMISES SCOTTSDALE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF REVENUE CYCLE
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:MAPLESDEN
Authorized Official - Suffix:
Authorized Official - Credentials:CPC, CHC, CHPC
Authorized Official - Phone:615-510-3078
Mailing Address - Street 1:PO BOX 670595
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-0595
Mailing Address - Country:US
Mailing Address - Phone:615-567-7282
Mailing Address - Fax:
Practice Address - Street 1:11624 E SHEA BLVD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85259-5111
Practice Address - Country:US
Practice Address - Phone:480-840-2588
Practice Address - Fax:480-767-2701
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ELEMENTS BEHAVIORAL HEALTH, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-01-03
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder