| The Aurora Group | |
|
6015 W Peoria Ave Glendale AZ 85302-1207 | |
| (623) 344-4400 | |
| (623) 344-4450 |
| Full Name | The Aurora Group |
|---|---|
| Speciality | Psychiatric Hospital |
| Location | 6015 W Peoria Ave, Glendale, Arizona |
| Authorized Official Name and Position | Soon K Kim (OWNER/AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 2489055091 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Aurora Group 6015 W Peoria Ave Glendale AZ 85302-1207 Ph: (623) 344-4400 | The Aurora Group 6015 W Peoria Ave Glendale AZ 85302-1207 Ph: (623) 344-4400 |
| NPI Number | 1730388349 |
|---|---|
| Provider Enumeration Date | 07/13/2007 |
| Last Update Date | 11/04/2020 |
| Certification Date | 11/04/2020 |
| Medicare PECOS PAC ID | 5698772887 |
|---|---|
| Medicare Enrollment ID | O20071219000478 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730388349 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Secondary |
| 283Q00000X | Psychiatric Hospital | (* (Not Available)) | Primary |
| Provider Name | Shawn Matthews |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265965453 PECOS PAC ID: 1850772377 Enrollment ID: I20240124003220 |
| Provider Name | Andrew Alix |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396326005 PECOS PAC ID: 7315342870 Enrollment ID: I20240306004124 |
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