| Upc-outpatient Obs Suite 150b | |
|
1201 S 7th Ave Ste 150b Phoenix AZ 85007-4075 | |
| (602) 416-7600 | |
| (866) 882-5456 |
| Full Name | Upc-outpatient Obs Suite 150b |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1201 S 7th Ave Ste 150b, Phoenix, Arizona |
| Authorized Official Name and Position | Janice Talas-denny (PROVIDER NETWORK MANAGEMENT ASSOC) |
| Authorized Official Contact | 6024167647 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Upc-outpatient Obs Suite 150b 2390 E Camelback Rd Ste 400 Phoenix AZ 85016-3479 Ph: (602) 253-5100 | Upc-outpatient Obs Suite 150b 1201 S 7th Ave Ste 150b Phoenix AZ 85007-4075 Ph: (602) 416-7600 |
| NPI Number | 1972985547 |
|---|---|
| Provider Enumeration Date | 06/19/2015 |
| Last Update Date | 03/03/2023 |
| Certification Date | 03/03/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972985547 | NPI | - | NPPES |
| Z222888 | Other | AZ | MEDICARE |
| 104321 | Medicaid | AZ | |
| OTC9274 | Other | AZ | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | OTC7440 (Arizona) | Primary |
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