Provider Demographics
NPI:1184315640
Name:IRONWOOD BEHAVIORAL HEALTH, LLC
Entity type:Organization
Organization Name:IRONWOOD BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:LEICKEN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:602-910-4050
Mailing Address - Street 1:8041 E WHISPERING WIND DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-2839
Mailing Address - Country:US
Mailing Address - Phone:480-767-3599
Mailing Address - Fax:
Practice Address - Street 1:8124 E CACTUS RD STE 410
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-5262
Practice Address - Country:US
Practice Address - Phone:602-910-4050
Practice Address - Fax:480-885-1985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty