| Devine Care Outpatient Center | |
|
10240 N 31st Ave Ste 122 Phoenix AZ 85051-9564 | |
| (623) 330-6269 | |
| Not Available |
| Full Name | Devine Care Outpatient Center |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 10240 N 31st Ave Ste 122, Phoenix, Arizona |
| Authorized Official Name and Position | David Oriabure (ADMINISTRATOR) |
| Authorized Official Contact | 6233306269 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Devine Care Outpatient Center 10240 N 31st Ave Ste 122 Phoenix AZ 85051-9564 Ph: (623) 330-6269 | Devine Care Outpatient Center 10240 N 31st Ave Ste 122 Phoenix AZ 85051-9564 Ph: (623) 330-6269 |
| NPI Number | 1245969245 |
|---|---|
| Provider Enumeration Date | 06/07/2022 |
| Last Update Date | 10/04/2023 |
| Certification Date | 10/04/2023 |
| Medicare PECOS PAC ID | 9739538257 |
|---|---|
| Medicare Enrollment ID | O20231209000245 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245969245 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
| Provider Name | Rosine Ndayikeze Oriabure |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083268874 PECOS PAC ID: 3274863105 Enrollment ID: I20190919001318 |
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