Provider Demographics
NPI:1720813850
Name:VALLEY PSYCHIATRY PLLC
Entity type:Organization
Organization Name:VALLEY PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:BACKENS
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:602-932-9302
Mailing Address - Street 1:9647 W BENT TREE DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-8719
Mailing Address - Country:US
Mailing Address - Phone:602-326-5466
Mailing Address - Fax:
Practice Address - Street 1:12802 N CAVE CREEK RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-5825
Practice Address - Country:US
Practice Address - Phone:602-932-9302
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)