Provider Demographics
NPI:1962548388
Name:RIO SALADO BEHAVIORAL HEALTH SYSTEMS, INC.
Entity type:Organization
Organization Name:RIO SALADO BEHAVIORAL HEALTH SYSTEMS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TINO
Authorized Official - Middle Name:
Authorized Official - Last Name:DEANDA
Authorized Official - Suffix:
Authorized Official - Credentials:LBSW MBA
Authorized Official - Phone:602-252-9048
Mailing Address - Street 1:1308 W CAMELBACK RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-2107
Mailing Address - Country:US
Mailing Address - Phone:602-252-9048
Mailing Address - Fax:602-252-7340
Practice Address - Street 1:1308 W CAMELBACK RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-2107
Practice Address - Country:US
Practice Address - Phone:602-252-9048
Practice Address - Fax:602-252-7340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH2194251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health