Provider Demographics
NPI:1548980725
Name:BRANCH INTERNATIONAL INC
Entity type:Organization
Organization Name:BRANCH INTERNATIONAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BILLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-955-8151
Mailing Address - Street 1:PO BOX 32181
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85064-2181
Mailing Address - Country:US
Mailing Address - Phone:520-955-8151
Mailing Address - Fax:
Practice Address - Street 1:4655 S 16TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85040-2327
Practice Address - Country:US
Practice Address - Phone:602-621-7571
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-30
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes202D00000XAllopathic & Osteopathic PhysiciansIntegrative MedicineGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children