| Genrev Family Resource | |
|
8537 W Wilshire Dr Phoenix AZ 85037-3710 | |
| (602) 505-2683 | |
| Not Available |
| Full Name | Genrev Family Resource |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 8537 W Wilshire Dr, Phoenix, Arizona |
| Authorized Official Name and Position | Darnell Colbert (CEO) |
| Authorized Official Contact | 6025052683 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Genrev Family Resource 2512 E Thomas Rd Ste 9 Phoenix AZ 85016-7937 Ph: () - | Genrev Family Resource 8537 W Wilshire Dr Phoenix AZ 85037-3710 Ph: (602) 505-2683 |
| NPI Number | 1730577263 |
|---|---|
| Provider Enumeration Date | 01/07/2015 |
| Last Update Date | 01/09/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730577263 | NPI | - | NPPES |
| BH4495 | Other | AZ | MERCY CARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | BH4495 (Arizona) | Primary |
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