| New Haven Mental Health Pllc | |
|
459 N Gilbert Rd Gilbert AZ 85234-4591 | |
| (480) 999-9999 | |
| Not Available |
| Full Name | New Haven Mental Health Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 459 N Gilbert Rd, Gilbert, Arizona |
| Authorized Official Name and Position | Tallan Depriest (DIRECTOR) |
| Authorized Official Contact | 4809999999 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Haven Mental Health Pllc 1628 E Southern Ave # 935 Tempe AZ 85282-5782 Ph: () - | New Haven Mental Health Pllc 459 N Gilbert Rd Gilbert AZ 85234-4591 Ph: (480) 999-9999 |
| NPI Number | 1063082386 |
|---|---|
| Provider Enumeration Date | 06/29/2021 |
| Last Update Date | 03/02/2022 |
| Certification Date | 03/02/2022 |
| Medicare PECOS PAC ID | 1153700299 |
|---|---|
| Medicare Enrollment ID | O20220621002527 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063082386 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Tallan T Depriest |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548794399 PECOS PAC ID: 0547531105 Enrollment ID: I20211021002747 |
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