Provider Demographics
| NPI: | 1033937784 |
|---|---|
| Name: | BROWN BEHAVIORAL HEALTH SERVICES |
| Entity type: | Organization |
| Organization Name: | BROWN BEHAVIORAL HEALTH SERVICES |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | DIRECTOR/CEO |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | KETURAH |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | MATTOX SHARPE |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | MBA/HCM, MED, MA |
| Authorized Official - Phone: | 623-302-4009 |
| Mailing Address - Street 1: | 2917 W BOWKER ST |
| Mailing Address - Street 2: | |
| Mailing Address - City: | PHOENIX |
| Mailing Address - State: | AZ |
| Mailing Address - Zip Code: | 85041-3477 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 623-302-4009 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 7900 N 70TH AVE STE 102 |
| Practice Address - Street 2: | |
| Practice Address - City: | GLENDALE |
| Practice Address - State: | AZ |
| Practice Address - Zip Code: | 85303-1336 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 623-302-4009 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2024-10-01 |
| Last Update Date: | 2024-10-01 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 261QH0100X | Ambulatory Health Care Facilities | Clinic/Center | Health Service |
| No | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
| No | 251B00000X | Agencies | Case Management | |
| No | 251C00000X | Agencies | Day Training, Developmentally Disabled Services | |
| No | 251K00000X | Agencies | Public Health or Welfare | |
| No | 251S00000X | Agencies | Community/Behavioral Health | |
| No | 253Z00000X | Agencies | In Home Supportive Care | |
| No | 261QC1500X | Ambulatory Health Care Facilities | Clinic/Center | Community Health |
| No | 261QD1600X | Ambulatory Health Care Facilities | Clinic/Center | Developmental Disabilities |
| No | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health |
| No | 261QP0905X | Ambulatory Health Care Facilities | Clinic/Center | Public Health, State or Local |
| No | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder |
| No | 3245S0500X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | Substance Abuse Treatment, Children |
| No | 332800000X | Suppliers | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
