| Reverie Mind, Llc | |
|
4055 W Chandler Blvd Ste 5 Chandler AZ 85226-3700 | |
| (480) 590-0092 | |
| Not Available |
| Full Name | Reverie Mind, Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 4055 W Chandler Blvd Ste 5, Chandler, Arizona |
| Authorized Official Name and Position | Robert Wallace (CEO) |
| Authorized Official Contact | 4808286575 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Reverie Mind, Llc 4055 W Chandler Blvd Ste 5 Chandler AZ 85226-3700 Ph: (480) 590-0092 | Reverie Mind, Llc 4055 W Chandler Blvd Ste 5 Chandler AZ 85226-3700 Ph: (480) 590-0092 |
| NPI Number | 1407686033 |
|---|---|
| Provider Enumeration Date | 08/07/2024 |
| Last Update Date | 08/07/2024 |
| Certification Date | 08/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407686033 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
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