Provider Demographics
NPI:1972980522
Name:PRS NEUROHEALTH SOLUTIONS, LLC
Entity type:Organization
Organization Name:PRS NEUROHEALTH SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF RESEARCH & TECHNOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:OWEN
Authorized Official - Last Name:SOUTHLAND
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:480-696-5796
Mailing Address - Street 1:17470 N PACESETTER WAY
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-5445
Mailing Address - Country:US
Mailing Address - Phone:480-696-5796
Mailing Address - Fax:
Practice Address - Street 1:60 E RIO SALADO PKWY
Practice Address - Street 2:SUITE 900
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-9124
Practice Address - Country:US
Practice Address - Phone:480-696-5796
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-04
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty