Provider Demographics
NPI:1861113185
Name:SEQUOIA BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:SEQUOIA BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:PARSONS
Authorized Official - Suffix:
Authorized Official - Credentials:AASM
Authorized Official - Phone:928-460-0862
Mailing Address - Street 1:9221 E BASELINE RD
Mailing Address - Street 2:STE 109 #443
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85209
Mailing Address - Country:US
Mailing Address - Phone:928-460-0862
Mailing Address - Fax:
Practice Address - Street 1:5525 S COYOTE CYN
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85212-9149
Practice Address - Country:US
Practice Address - Phone:928-460-0862
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility