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455 S 48th St Ste 109 Tempe AZ 85281-2302 | |
| (480) 945-2558 | |
| (480) 945-2354 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 455 S 48th St Ste 109, Tempe, Arizona |
| Authorized Official Name and Position | Ekram Ebrahim (OWNER/MANAGER) |
| Authorized Official Contact | 4809452558 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
455 S 48th St Ste 109 Tempe AZ 85281-2302 Ph: (480) 945-2558 | 455 S 48th St Ste 109 Tempe AZ 85281-2302 Ph: (480) 945-2558 |
| NPI Number | 1023401965 |
|---|---|
| Provider Enumeration Date | 03/17/2015 |
| Last Update Date | 09/03/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023401965 | 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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