Denova Collaborative Health

LBN: Denova Collaborative Health, Llc
Denova Collaborative Health is an health care organization with primary practice located at 2204 S Dobson Rd Ste 102 , Mesa AZ 85202-6457. The organization recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Psychiatry, Ambulatory Health Care Facilities / Multi-Specialty. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty. Denova Collaborative Health, Llc can be contacted via phone (602) 230-7373, or through Johnson, Graham via phone (602) 230-7373.

Contact Information

Primary practice address
2204 S Dobson Rd Ste 102 Mesa AZ 85202-6457
Phone: (602) 230-7373
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Johnson, Graham
Phone: (602) 230-7373

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X Arizona
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X Arizona
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X Arizona
Ambulatory Health Care Facilities / Multi-Specialty 261QM1300X

Profile Details

NPI number 1124549043
LBN Legal business name Denova Collaborative Health, Llc
DBA Doing business as Denova Collaborative Health
Authorized official Johnson, Graham
Entity Organization
Organization subpart 1 No
Enumeration date Jun 30th, 2017
Last updated Jun 5th, 2024 - about 6 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124549043 NPPES
Arizona MEDICAID PENDING

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