| Grossman & Grossman, Ltd. | |
|
1300 N 12th St Ste 550 Phoenix AZ 85006-2820 | |
| (602) 468-2077 | |
| (480) 609-9552 |
| Full Name | Grossman & Grossman, Ltd. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1300 N 12th St Ste 550, Phoenix, Arizona |
| Authorized Official Name and Position | Jon Birdell Grossman (PRESIDENT/EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6024106637 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grossman & Grossman, Ltd. Po Box 14948 Scottsdale AZ 85267 Ph: (602) 410-6635 | Grossman & Grossman, Ltd. 1300 N 12th St Ste 550 Phoenix AZ 85006-2820 Ph: (602) 468-2077 |
| NPI Number | 1245679620 |
|---|---|
| Provider Enumeration Date | 06/19/2013 |
| Last Update Date | 08/11/2022 |
| Certification Date | 08/11/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245679620 | NPI | - | NPPES |
| 825703 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | BH4275 (Arizona) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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