Provider Demographics
NPI:1861855702
Name:TOUCHSTONE BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:TOUCHSTONE BEHAVIORAL HEALTH
Other - Org Name:TOUCHSTONE HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF QUALITY OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:EGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MAED, LPC
Authorized Official - Phone:623-692-7409
Mailing Address - Street 1:15820 N 35TH AVE STE 14
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85053-7608
Mailing Address - Country:US
Mailing Address - Phone:866-207-3882
Mailing Address - Fax:602-732-5480
Practice Address - Street 1:12409 W INDIAN SCHOOL RD BLDG E
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-9502
Practice Address - Country:US
Practice Address - Phone:602-732-4950
Practice Address - Fax:602-732-5480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-29
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ251S00000X
261QP2300X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ105348OtherMEDICARE
AZ305629Medicaid
AZOTC7749OtherADHS LICENSE