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2131 E Broadway Rd Ste 13-19&21 Tempe AZ 85282-1737 | |
| (480) 967-6895 | |
| (480) 967-4986 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2131 E Broadway Rd Ste 13-19&21, Tempe, Arizona |
| Authorized Official Name and Position | Nancy Poe (CONTRACTS ADMINISTRATOR) |
| Authorized Official Contact | 5205701460 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2131 E Broadway Rd Suite #14 Tempe AZ 85282 Ph: (480) 967-6895 | 2131 E Broadway Rd Ste 13-19&21 Tempe AZ 85282-1737 Ph: (480) 967-6895 |
| NPI Number | 1114461779 |
|---|---|
| Provider Enumeration Date | 12/15/2016 |
| Last Update Date | 10/09/2024 |
| Certification Date | 10/09/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114461779 | NPI | - | NPPES |
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