Active Integrated Health | |
12402 W Soledad St El Mirage AZ 85335-7244 | |
(623) 262-8239 | |
Not Available |
Full Name | Active Integrated Health |
---|---|
Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 12402 W Soledad St, El Mirage, Arizona |
Authorized Official Name and Position | Bryce Bellue (PART OWNER) |
Authorized Official Contact | 6235058198 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Active Integrated Health 12402 W Soledad St El Mirage AZ 85335-7244 Ph: () - | Active Integrated Health 12402 W Soledad St El Mirage AZ 85335-7244 Ph: (623) 262-8239 |
NPI Number | 1366112609 |
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Provider Enumeration Date | 09/17/2021 |
Last Update Date | 09/17/2021 |
Certification Date | 09/15/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1366112609 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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