# ARIZONA ESSENTIAL HOLISTIC CARE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Arizona Essential Holistic Care, LLC, Arizona Essential Holistic Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497246482
- **Authorized official:** ALODIA BANUELOS DOMINGO (PROVIDER/OWNER)
- **Authorized official phone:** (623) 738-6062

## Contact information

- **Practice address:** 5700 W OLIVE AVE STE 102, GLENDALE, AZ 85302
- **Practice address phone:** (623) 738-6062
- **Practice address fax:** (602) 354-9462
- **Mailing address:** 5700 W OLIVE AVE STE 102, GLENDALE, AZ 85302-3147
- **Mailing address phone:** (602) 738-6062
- **Mailing address fax:** (602) 354-9462

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | AP5625 | AZ | Yes |

## Other

- **Enumeration date:** 05/24/2018
- **Last updated:** 11/25/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 811065660 | UNITED HEALTH CARE | AZ |