OrganizationActive
101 Wall Support Services LLC
NPI 1568804342 · Community/Behavioral Health Agency · Mesa, AZ
Provider details
- NPI number
- 1568804342
- Entity type
- Organization
- Primary specialty
- Community/Behavioral Health AgencyAgencies
- Authorized official
- Jonathan Taylor, Chief Executive Officer
- License
- BH-4204 (AZ)
Practice location
919 N Stapley Dr
Suite M
Mesa, AZ 85203-5639
Phone: (480) 285-9426
Fax: (480) 907-1358
Mailing address
919 N Stapley Dr
Mesa, AZ 85203-5639
Registry dates
- Enumerated
- 2013-07-23
- Last updated
- 2013-07-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.