| Spark Healthcare Llc | |
|
8906 North 80th Place Scottsdale AZ 85258-2132 | |
| (602) 962-6515 | |
| (602) 962-6515 |
| Full Name | Spark Healthcare Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 8906 North 80th Place, Scottsdale, Arizona |
| Authorized Official Name and Position | Ralph John Massetti (CEO) |
| Authorized Official Contact | 4802270630 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Spark Healthcare Llc 8390 E Via De Ventura Ste F110-301 Scottsdale AZ 85258-3188 Ph: (602) 962-6515 | Spark Healthcare Llc 8906 North 80th Place Scottsdale AZ 85258-2132 Ph: (602) 962-6515 |
| NPI Number | 1174148076 |
|---|---|
| Provider Enumeration Date | 06/16/2020 |
| Last Update Date | 06/16/2020 |
| Certification Date | 06/16/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174148076 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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