Center Street | |
5949 W Northern Ave Ste 201 Glendale AZ 85301-7829 | |
(323) 233-1675 | |
Not Available |
Full Name | Center Street |
---|---|
Speciality | Clinic/center - Rehabilitation |
Location | 5949 W Northern Ave Ste 201, Glendale, Arizona |
Authorized Official Name and Position | Nilah Emage Asy Jamie Quinones (OWNER) |
Authorized Official Contact | 3233167585 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Center Street 2739 W Rancho Dr Phoenix AZ 85017-2645 Ph: () - | Center Street 5949 W Northern Ave Ste 201 Glendale AZ 85301-7829 Ph: (323) 233-1675 |
NPI Number | 1790401388 |
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Provider Enumeration Date | 10/14/2022 |
Last Update Date | 10/18/2022 |
Certification Date | 10/18/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1790401388 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
261QR0400X | Clinic/center - Rehabilitation | (* (Not Available)) | Primary |
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