| Ndns4wellness | |
|
4520 N Central Ave Ste 130 Phoenix AZ 85012-1804 | |
| (602) 424-1600 | |
| (602) 532-7202 |
| Full Name | Ndns4wellness |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4520 N Central Ave Ste 130, Phoenix, Arizona |
| Authorized Official Name and Position | Bonny Beach (CEO) |
| Authorized Official Contact | 6024241600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ndns4wellness Po Box 25047 Phoenix AZ 85002-5047 Ph: (602) 424-1600 | Ndns4wellness 4520 N Central Ave Ste 130 Phoenix AZ 85012-1804 Ph: (602) 424-1600 |
| NPI Number | 1407071095 |
|---|---|
| Provider Enumeration Date | 04/17/2007 |
| Last Update Date | 06/25/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407071095 | NPI | - | NPPES |
| 790255 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | BH-3105 (Arizona) | Primary |
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