Provider Demographics
NPI:1346680162
Name:ADULT AND CHILDREN THERAPEUTIC SERVICES
Entity type:Organization
Organization Name:ADULT AND CHILDREN THERAPEUTIC SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COOWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:HARR
Authorized Official - Suffix:
Authorized Official - Credentials:BA PSYCHOLOGY
Authorized Official - Phone:602-616-0957
Mailing Address - Street 1:325 N ALMA SCHOOL RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-4379
Mailing Address - Country:US
Mailing Address - Phone:602-616-0957
Mailing Address - Fax:480-883-8132
Practice Address - Street 1:325 N ALMA SCHOOL RD
Practice Address - Street 2:SUITE 1
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-4379
Practice Address - Country:US
Practice Address - Phone:602-616-0957
Practice Address - Fax:480-883-8132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-25
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC12333101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty