Provider Demographics
NPI:1104998301
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
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85053-7606
Mailing Address - Country:US
Mailing Address - Phone:866-207-3882
Mailing Address - Fax:623-209-0112
Practice Address - Street 1:1430 E FORT LOWELL RD STE 100
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-2366
Practice Address - Country:US
Practice Address - Phone:520-745-5244
Practice Address - Fax:520-747-1846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH-2760251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ151359OtherAHCCCS ID
AZOTC8472OtherADHS LICENSE