| Empact-spc | |
|
2474 E Hunt Hwy Ste 100 San Tan Valley AZ 85143-5210 | |
| (480) 784-1514 | |
| (480) 967-3528 |
| Full Name | Empact-spc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2474 E Hunt Hwy Ste 100, San Tan Valley, Arizona |
| Authorized Official Name and Position | Brittany Rasmussen (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 4808689479 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Empact-spc 2474 E Hunt Hwy Ste 100 San Tan Valley AZ 85143-5210 Ph: (480) 784-1514 | Empact-spc 2474 E Hunt Hwy Ste 100 San Tan Valley AZ 85143-5210 Ph: (480) 784-1514 |
| NPI Number | 1215311378 |
|---|---|
| Provider Enumeration Date | 07/17/2015 |
| Last Update Date | 10/03/2023 |
| Certification Date | 03/23/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215311378 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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