Provider First Line Business Practice Location Address:
16010 N 28TH AVE
Provider Second Line Business Practice Location Address:
TRIWEST CORPORATE BEHAVIORAL HEALTH
Provider Business Practice Location Address City Name:
PHOENIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85053-4049
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-874-9378
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/16/2007