| Valle Del Sol, Inc. | |
|
1209 S 1st Ave Phoenix AZ 85003-2605 | |
| (602) 258-6797 | |
| (602) 254-7121 |
| Full Name | Valle Del Sol, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1209 S 1st Ave, Phoenix, Arizona |
| Authorized Official Name and Position | Rebecca Razo (DIRECTOR OF CONTRACTS AND LICENSING) |
| Authorized Official Contact | 6022586797 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Valle Del Sol, Inc. 3877 N 7th St Ste 400 Phoenix AZ 85014-5061 Ph: (602) 258-6797 | Valle Del Sol, Inc. 1209 S 1st Ave Phoenix AZ 85003-2605 Ph: (602) 258-6797 |
| NPI Number | 1578709002 |
|---|---|
| Provider Enumeration Date | 01/06/2009 |
| Last Update Date | 06/07/2024 |
| Certification Date | 06/07/2024 |
| Medicare PECOS PAC ID | 8628019148 |
|---|---|
| Medicare Enrollment ID | O20200406002893 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578709002 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | OTC-5153 (Arizona) | Secondary |
| 251S00000X | Community/behavioral Health | OTC5153 (Arizona) | Primary |
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