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1001 E Warner Rd Ste 104 Tempe AZ 85284-3224 | |
| (480) 504-2676 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1001 E Warner Rd Ste 104, Tempe, Arizona |
| Authorized Official Name and Position | Ramon Weaver (ADMINISTRATOR) |
| Authorized Official Contact | 4805042676 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1007 E Warner Rd Ste 110 Tempe AZ 85284-3242 Ph: (480) 504-2676 | 1001 E Warner Rd Ste 104 Tempe AZ 85284-3224 Ph: (480) 504-2676 |
| NPI Number | 1821856949 |
|---|---|
| Provider Enumeration Date | 03/12/2024 |
| Last Update Date | 06/15/2024 |
| Certification Date | 06/15/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821856949 | NPI | - | NPPES |
| 13371 | Other | AZ | LICENSE |
| 189006 | Medicaid | AZ |
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