Provider Demographics
NPI:1881641215
Name:WEST VALLEY PSYCHIATRIC ASSOCIATES
Entity Type:Organization
Organization Name:WEST VALLEY PSYCHIATRIC ASSOCIATES
Other - Org Name:HUMAN DEVELOPMENT CENTRE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:BUTZINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-214-1141
Mailing Address - Street 1:14506 W GRANITE VALLEY DR
Mailing Address - Street 2:STE 108
Mailing Address - City:SUN CITY WEST
Mailing Address - State:AZ
Mailing Address - Zip Code:85375
Mailing Address - Country:US
Mailing Address - Phone:623-214-1141
Mailing Address - Fax:623-214-8903
Practice Address - Street 1:14506 W GRANITE VALLEY DR
Practice Address - Street 2:STE 108
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375
Practice Address - Country:US
Practice Address - Phone:623-214-1141
Practice Address - Fax:623-214-8903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-30
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ396440121Medicare ID - Type Unspecified
AZZ28837Medicare PIN