| O&t Health And Wellness Center Llc | |
|
2516 E University Dr Ste 200 Phoenix AZ 85034-6907 | |
| (480) 915-5395 | |
| Not Available |
| Full Name | O&t Health And Wellness Center Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2516 E University Dr Ste 200, Phoenix, Arizona |
| Authorized Official Name and Position | Temilola Yewande Afelumo (ADMIN) |
| Authorized Official Contact | 4809155395 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| O&t Health And Wellness Center Llc 5148 W Topeka Dr Glendale AZ 85308-4944 Ph: (480) 915-5395 | O&t Health And Wellness Center Llc 2516 E University Dr Ste 200 Phoenix AZ 85034-6907 Ph: (480) 915-5395 |
| NPI Number | 1588442818 |
|---|---|
| Provider Enumeration Date | 09/18/2023 |
| Last Update Date | 09/20/2023 |
| Certification Date | 09/20/2023 |
| Medicare PECOS PAC ID | 8224477500 |
|---|---|
| Medicare Enrollment ID | O20240419000374 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588442818 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Adebukola Y Aladesanmi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568179877 PECOS PAC ID: 6608247978 Enrollment ID: I20230124002372 |
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