| Willow Stream Llc | |
|
233 E Southern Ave Unit 25237 Tempe AZ 85285-0076 | |
| (844) 647-2926 | |
| Not Available |
| Full Name | Willow Stream Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 233 E Southern Ave Unit 25237, Tempe, Arizona |
| Authorized Official Name and Position | Misa Yanagisawa (OWNER) |
| Authorized Official Contact | 8446472926 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Willow Stream Llc 233 E Southern Ave Unit 25237 Tempe AZ 85285-0076 Ph: (844) 647-2926 | Willow Stream Llc 233 E Southern Ave Unit 25237 Tempe AZ 85285-0076 Ph: (844) 647-2926 |
| NPI Number | 1073352332 |
|---|---|
| Provider Enumeration Date | 05/24/2024 |
| Last Update Date | 05/24/2024 |
| Certification Date | 05/24/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073352332 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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