Provider Demographics
NPI:1174311922
Name:TEEVAGA BEHAVIORAL HEALTH SERVICES LLC
Entity type:Organization
Organization Name:TEEVAGA BEHAVIORAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/BHT
Authorized Official - Prefix:
Authorized Official - First Name:EFEEVELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:AGBIWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-202-5465
Mailing Address - Street 1:7935 W ATLANTIS WAY
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85043-1638
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7935 W ATLANTIS WAY
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85043-1638
Practice Address - Country:US
Practice Address - Phone:480-202-5465
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health