Provider Demographics
NPI:1134383318
Name:ARIZONA MENTAL HEALTH INSTITUTE, L.L.C.
Entity type:Organization
Organization Name:ARIZONA MENTAL HEALTH INSTITUTE, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TOBIN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:623-435-6443
Mailing Address - Street 1:6802 N 47TH AVE
Mailing Address - Street 2:SUITE #1
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85301-3599
Mailing Address - Country:US
Mailing Address - Phone:623-435-6443
Mailing Address - Fax:623-435-6454
Practice Address - Street 1:6802 N 47TH AVE
Practice Address - Street 2:SUITE #1
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85301-3599
Practice Address - Country:US
Practice Address - Phone:623-435-6443
Practice Address - Fax:623-435-6454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP1277251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ772592Medicare UPIN