Provider Demographics
NPI:1962641621
Name:TRIPLE R BEHAVIORAL HEALTH, INC.
Entity Type:Organization
Organization Name:TRIPLE R BEHAVIORAL HEALTH, INC.
Other - Org Name:RAIVEN GARDENS
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOCHSTRASSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-995-7474
Mailing Address - Street 1:40 E MITCHELL DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2330
Mailing Address - Country:US
Mailing Address - Phone:602-995-7474
Mailing Address - Fax:
Practice Address - Street 1:4017 N 40TH ST
Practice Address - Street 2:SUITE 2
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-5243
Practice Address - Country:US
Practice Address - Phone:602-955-3288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-19
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH-2242251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health