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601 W Rio Salado Pkwy Tempe AZ 85281-0099 | |
| (725) 777-9971 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 601 W Rio Salado Pkwy, Tempe, Arizona |
| Authorized Official Name and Position | Jamie Reid (ADMINISTRATOR/OWNER) |
| Authorized Official Contact | 7257779971 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
601 W Rio Salado Pkwy Apt 1079 Tempe AZ 85281-0109 Ph: (725) 777-9971 | 601 W Rio Salado Pkwy Tempe AZ 85281-0099 Ph: (725) 777-9971 |
| NPI Number | 1760111835 |
|---|---|
| Provider Enumeration Date | 06/06/2022 |
| Last Update Date | 02/01/2023 |
| Certification Date | 02/01/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760111835 | NPI | - | NPPES |
| 0 | Other | AZ | NA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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