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1631 E Don Carlos Ave Suite 107 And 108 Tempe AZ 85281-4301 | |
| (480) 967-2299 | |
| (480) 966-2692 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1631 E Don Carlos Ave, Tempe, Arizona |
| Authorized Official Name and Position | Wayne Hochstrasser (PRESIDENT/CEO) |
| Authorized Official Contact | 6029957474 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
40 E Mitchell Dr Suite 100 Phoenix AZ 85012-2330 Ph: (602) 995-7474 | 1631 E Don Carlos Ave Suite 107 And 108 Tempe AZ 85281-4301 Ph: (480) 967-2299 |
| NPI Number | 1477792596 |
|---|---|
| Provider Enumeration Date | 02/12/2009 |
| Last Update Date | 02/12/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477792596 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | BH2242 (Arizona) | Primary |
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