03D2134071 CLIA NUMBER - DENOVA COLLABORATIVE HEALTH - DOBSON RANCH

Laboratory Demographics

CLIA Number: 03D2134071

Facility Name: DENOVA COLLABORATIVE HEALTH - DOBSON RANCH

Facility Address:
2204 S DOBSON RD STE 102
MESA, AZ
ZIP 85202
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Facility Phone Number: 602 230-7373

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1043671324

Taxonomy: 251S00000X - Community/Behavioral Health
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

CLIA Record

Field Name	Field Value
CLIA Number	03D2134071
LAB Type	Community Clinic
Facility Name	DENOVA COLLABORATIVE HEALTH - DOBSON RANCH
Street	2204 S DOBSON RD STE 102
City	MESA
State	AZ
ZIP	85202
Phone	602 230-7373
CertificateType	4
CertificateEffectiveDate	7/25/2023
CertificateExpirationDate	7/24/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024