Provider Demographics
NPI:1962802801
Name:AURORA BEHAVIORAL HEALTH SYSTEMS, LLC
Entity type:Organization
Organization Name:AURORA BEHAVIORAL HEALTH SYSTEMS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE VP
Authorized Official - Prefix:
Authorized Official - First Name:HANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ATTAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-905-5091
Mailing Address - Street 1:6015 W PEORIA AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85302-1213
Mailing Address - Country:US
Mailing Address - Phone:623-344-4400
Mailing Address - Fax:623-344-4450
Practice Address - Street 1:6015 W PEORIA AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85302-1213
Practice Address - Country:US
Practice Address - Phone:623-344-4400
Practice Address - Fax:623-344-4450
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AURORA BEHAVIORAL HEALTH SYSTEMS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-08-28
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & NeuropsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ034024Medicare Oscar/Certification
AZZ119062Medicare PIN