Ptl Behavioral Health, LLC

NPI #1003344367 in Mesa, Arizona

Provider Information

NPI Number: 1003344367
Entity Type: Organization
Organization Name: Ptl Behavioral Health, LLC
Primary Specialty: Community Based Residential Treatment Facility, Mental Illness
Enumeration Date: May 31, 2017
Last Updated: Jul 21, 2022

Practice Location

Address: 10839 E SONRISA AVE
City: Mesa
State: Arizona
ZIP Code: 85212-5126
Phone: (480) 485-6075

Authorized Official

Name: MR. STEPHEN KISSI LAUDER SR.
Title: ADMINISTRATOR
Phone: (480) 516-9075

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Mental Illness	320800000X	Primary

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