Provider First Line Business Practice Location Address:
570 W BROWN RD
Provider Second Line Business Practice Location Address:
DESERT VITA BEHAVIORAL CENTER
Provider Business Practice Location Address City Name:
MESA
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85201-3227
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-344-2037
Provider Business Practice Location Address Fax Number:
480-344-2155
Provider Enumeration Date:
07/10/2006