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Organization
FEED CORP
Active
Organization
FEED CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUMMER FAUSSETTE (CEO)
(623) 703-5574
Entity
Organization
Contact information
Practice address
3838 N CENTRAL AVE STE 1850, PHOENIX, AZ 85012-1983
(602) 848-2325
Mailing address
3838 N CENTRAL AVE STE 1850, PHOENIX, AZ 85012-1983
(602) 848-2325
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
106S00000X
Behavior Technician
—
NULL
106S00000X
Behavior Technician
—
—
175T00000X
Peer Specialist
—
NULL
175T00000X
Peer Specialist
—
—
261QC1500X
Community Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
06/04/2022
Last updated
06/04/2022
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