| A Greater Vision Living Space Llc. | |
|
7252 W Quail Track Dr Peoria AZ 85383-6362 | |
| (623) 203-5920 | |
| Not Available |
| Full Name | A Greater Vision Living Space Llc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 7252 W Quail Track Dr, Peoria, Arizona |
| Authorized Official Name and Position | Crystal Roche (OWNER) |
| Authorized Official Contact | 6232035920 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| A Greater Vision Living Space Llc. 7252 W Quail Track Dr Peoria AZ 85383-6362 Ph: (623) 203-5920 | A Greater Vision Living Space Llc. 7252 W Quail Track Dr Peoria AZ 85383-6362 Ph: (623) 203-5920 |
| NPI Number | 1740974336 |
|---|---|
| Provider Enumeration Date | 06/06/2023 |
| Last Update Date | 06/28/2023 |
| Certification Date | 06/28/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740974336 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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