| Heart Song Wellness Llc | |
|
8715 W Union Hills Dr Ste 111 Peoria AZ 85382-3031 | |
| (425) 233-1732 | |
| (623) 248-7737 |
| Full Name | Heart Song Wellness Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 8715 W Union Hills Dr Ste 111, Peoria, Arizona |
| Authorized Official Name and Position | Karyn A Mackenzie Fajardo (OWNER) |
| Authorized Official Contact | 4252331732 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heart Song Wellness Llc 8715 W Union Hills Dr Ste 111 Peoria AZ 85382-3031 Ph: (425) 233-1732 | Heart Song Wellness Llc 8715 W Union Hills Dr Ste 111 Peoria AZ 85382-3031 Ph: (425) 233-1732 |
| NPI Number | 1073171153 |
|---|---|
| Provider Enumeration Date | 06/03/2019 |
| Last Update Date | 03/07/2022 |
| Certification Date | 03/07/2022 |
| Medicare PECOS PAC ID | 4183950744 |
|---|---|
| Medicare Enrollment ID | O20190719002701 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073171153 | NPI | - | NPPES |
| 1073171153 | Other | NPI | |
| 1154445062 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Karyn A Mackenzie Fajardo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154445062 PECOS PAC ID: 6002176294 Enrollment ID: I20180208000695 |
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