Provider Demographics
NPI:1871290106
Name:PUTTING U FIRST INTEGRATIVE BEHAVIORAL HEALTH & WELLNESS
Entity type:Organization
Organization Name:PUTTING U FIRST INTEGRATIVE BEHAVIORAL HEALTH & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:GOSLEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-299-8818
Mailing Address - Street 1:279 E GOLD DUST WAY
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85143-5882
Mailing Address - Country:US
Mailing Address - Phone:602-299-8818
Mailing Address - Fax:
Practice Address - Street 1:2538 E UNIVERSITY DR STE 200
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85034-6926
Practice Address - Country:US
Practice Address - Phone:602-607-5277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ05Medicaid