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Organization
ARIZONA ESSENTIAL HOLISTIC CARE
Active
Organization
ARIZONA ESSENTIAL HOLISTIC CARE
Active
Other names
Arizona Essential Holistic Care, LLC, Arizona Essential Holistic Care
Organization subpart
No
Provider details
NPI number
Authorized official
ALODIA BANUELOS DOMINGO (PROVIDER/OWNER)
(623) 738-6062
Entity
Organization
Contact information
Practice address
5700 W OLIVE AVE STE 102, GLENDALE, AZ 85302
(623) 738-6062
(602) 354-9462
Mailing address
5700 W OLIVE AVE STE 102, GLENDALE, AZ 85302-3147
(602) 738-6062
(602) 354-9462
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
AP5625
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
811065660
UNITED HEALTH CARE
AZ
Enumeration date
05/24/2018
Last updated
11/25/2019
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