Provider Demographics
NPI:1902594526
Name:CIRCLE CITY ABA OF ARIZONA LLC
Entity Type:Organization
Organization Name:CIRCLE CITY ABA OF ARIZONA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BILLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-767-7942
Mailing Address - Street 1:1801 E CAMELBACK RD STE 102
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4165
Mailing Address - Country:US
Mailing Address - Phone:602-767-7942
Mailing Address - Fax:855-915-0244
Practice Address - Street 1:8454 N 90TH ST
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4478
Practice Address - Country:US
Practice Address - Phone:602-767-7942
Practice Address - Fax:855-915-0244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-01
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty