|
| |
|
4667 S Lakeshore Dr Ste 7 Tempe AZ 85282-7293 | |
| (602) 851-8744 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4667 S Lakeshore Dr Ste 7, Tempe, Arizona |
| Authorized Official Name and Position | Ebony Cherise Brushbreaker (CO-OWNER) |
| Authorized Official Contact | 7024274537 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4667 S Lakeshore Dr Ste 7 Tempe AZ 85282-7293 Ph: (702) 427-4537 | 4667 S Lakeshore Dr Ste 7 Tempe AZ 85282-7293 Ph: (602) 851-8744 |
| NPI Number | 1346006434 |
|---|---|
| Provider Enumeration Date | 02/26/2024 |
| Last Update Date | 02/26/2024 |
| Certification Date | 02/26/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346006434 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Skycrest Neurology, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2600 E Southern Ave, #d1, Tempe, AZ 85282 Phone: 480-219-7272 | |
Empact-suicide Prevention Center Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 618 S. Madison Drive, Tempe, AZ 85281 Phone: 480-784-1514 Fax: 480-967-3528 | |
Avira Behavioral Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 64 E Broadway Rd Ste 200, Tempe, AZ 85282 Phone: 346-500-4514 | |