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509 S 48th St Ste 102 Tempe AZ 85281-2322 | |
| (602) 466-5982 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 509 S 48th St Ste 102, Tempe, Arizona |
| Authorized Official Name and Position | Abdulqadir Roble (CEO) |
| Authorized Official Contact | 6024665982 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 67636 Phoenix AZ 85082-7636 Ph: (602) 466-5982 | 509 S 48th St Ste 102 Tempe AZ 85281-2322 Ph: (602) 466-5982 |
| NPI Number | 1003522186 |
|---|---|
| Provider Enumeration Date | 01/23/2023 |
| Last Update Date | 02/23/2024 |
| Certification Date | 02/23/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003522186 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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