# AMYST HEALTHCARE INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023984788
- **Authorized official:** DWIGHT CLARK (CEO)
- **Authorized official phone:** (602) 887-9886

## Contact information

- **Practice address:** 10621 S 51ST ST STE 103, PHOENIX, AZ 85044-5207
- **Practice address phone:** (602) 887-9886
- **Practice address fax:** (602) 887-4975
- **Mailing address:** 10621 S 51ST ST STE 103, PHOENIX, AZ 85044-5207
- **Mailing address phone:** (602) 887-9886
- **Mailing address fax:** (602) 887-4975

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 163W00000X | Registered Nurse | — | NULL | — |
| 163W00000X | Registered Nurse | — | — | — |
| 163WH0200X | Home Health Registered Nurse | — | NULL | — |
| 163WH0200X | Home Health Registered Nurse | — | — | — |
| 224Z00000X | Occupational Therapy Assistant | — | NULL | — |
| 224Z00000X | Occupational Therapy Assistant | — | — | — |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |
| 251E00000X | Home Health Agency | — | NULL | Yes |
| 374U00000X | Home Health Aide | — | NULL | — |
| 374U00000X | Home Health Aide | — | — | — |

## Other

- **Enumeration date:** 10/10/2025
- **Last updated:** 10/10/2025