Provider Demographics
NPI:1629499165
Name:EBH SOUTHWEST SERVICES, INC.
Entity type:Organization
Organization Name:EBH SOUTHWEST SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, REVENUE CYCLE
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:MAPLESDEN
Authorized Official - Suffix:
Authorized Official - Credentials:CPC, CHC, CHPC
Authorized Official - Phone:615-510-3708
Mailing Address - Street 1:PO BOX 670595
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-9585
Mailing Address - Country:US
Mailing Address - Phone:615-567-7256
Mailing Address - Fax:
Practice Address - Street 1:12816 E TURQUOISE AVE
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85259-5300
Practice Address - Country:US
Practice Address - Phone:480-840-2588
Practice Address - Fax:480-773-7340
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ELEMENTS BEHAVORIAL HEALTH, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-12-31
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH4435324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility