# INNOVATIVE FAMILY HEALTH PRACTICES LLC

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

## Provider details

- **NPI number:** 1942866017
- **Authorized official:** RENEE DE JESUS (OWNER)
- **Authorized official phone:** (480) 892-7000

## Contact information

- **Practice address:** 4135 S POWER RD STE 120, MESA, AZ 85212-3626
- **Practice address phone:** (480) 892-7000
- **Practice address fax:** (480) 545-7001
- **Mailing address:** 4135 S POWER RD STE 120, MESA, AZ 85212-3626
- **Mailing address phone:** (480) 892-7000
- **Mailing address fax:** (480) 545-7001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/14/2019
- **Last updated:** 01/14/2020