Provider Demographics
NPI:1811627524
Name:TERI'S HEALTH SERVICES
Entity Type:Organization
Organization Name:TERI'S HEALTH SERVICES
Other - Org Name:TERI'S HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACCOUNT/CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:SWING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-318-3835
Mailing Address - Street 1:6635 W HAPPY VALLEY RD STE A104-621
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85310-2609
Mailing Address - Country:US
Mailing Address - Phone:602-358-7073
Mailing Address - Fax:888-927-0409
Practice Address - Street 1:203 S CANDY LN STE 6AB
Practice Address - Street 2:
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-4120
Practice Address - Country:US
Practice Address - Phone:602-358-7073
Practice Address - Fax:888-927-0409
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TERI HOURIHAN COUNSELING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-15
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ405477Medicaid