Provider Demographics
NPI:1063981462
Name:TOUCHSTONE BEHAVIORAL HEALTH
Entity type:Organization
Organization Name:TOUCHSTONE BEHAVIORAL HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF QUALITY OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:EGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MAED, LPC
Authorized Official - Phone:623-692-7409
Mailing Address - Street 1:15820 N 35TH AVE STE 14
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85053-7608
Mailing Address - Country:US
Mailing Address - Phone:866-207-3882
Mailing Address - Fax:602-732-5480
Practice Address - Street 1:15820 N 35TH AVE STE 16
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85053-7608
Practice Address - Country:US
Practice Address - Phone:866-207-3882
Practice Address - Fax:602-732-5480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-15
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZOTC12047OtherADHS LICENSE
AZ357279Medicaid