| Stand Tall Healing Center | |
|
3707 E. Southern Avenue Suite 2003 Mesa AZ 85206 | |
| (404) 788-5121 | |
| Not Available |
| Full Name | Stand Tall Healing Center |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 3707 E. Southern Avenue Suite 2003, Mesa, Arizona |
| Authorized Official Name and Position | Kayode J Wemimo (ADMINISTRATOR) |
| Authorized Official Contact | 6234147715 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stand Tall Healing Center 3707 E. Southern Avenue Suite 2003 Mesa AZ 85206 Ph: (404) 788-5121 | Stand Tall Healing Center 3707 E. Southern Avenue Suite 2003 Mesa AZ 85206 Ph: (404) 788-5121 |
| NPI Number | 1376232041 |
|---|---|
| Provider Enumeration Date | 05/08/2023 |
| Last Update Date | 06/05/2023 |
| Certification Date | 06/05/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376232041 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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