| Frontline Empire Llc | |
|
1310 E Southern Ave Mesa AZ 85204-5105 | |
| (817) 404-3365 | |
| Not Available |
| Full Name | Frontline Empire Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1310 E Southern Ave, Mesa, Arizona |
| Authorized Official Name and Position | Dan Nkotanyi (ADMINISTRATOR) |
| Authorized Official Contact | 8174043365 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Frontline Empire Llc 1310 E Southern Ave Mesa AZ 85204-5105 Ph: (817) 404-3365 | Frontline Empire Llc 1310 E Southern Ave Mesa AZ 85204-5105 Ph: (817) 404-3365 |
| NPI Number | 1194421172 |
|---|---|
| Provider Enumeration Date | 02/01/2023 |
| Last Update Date | 02/01/2023 |
| Certification Date | 02/01/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194421172 | NPI | - | NPPES |
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