Provider Demographics
NPI:1679047336
Name:DEHP LLC
Entity type:Organization
Organization Name:DEHP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSETTE
Authorized Official - Middle Name:D
Authorized Official - Last Name:SULLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-566-7627
Mailing Address - Street 1:3707 N 7TH ST STE 310
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-5014
Mailing Address - Country:US
Mailing Address - Phone:602-566-7627
Mailing Address - Fax:844-610-6047
Practice Address - Street 1:3707 N 7TH ST STE 310
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-5014
Practice Address - Country:US
Practice Address - Phone:602-566-7627
Practice Address - Fax:844-610-6047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-16
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty