Organization
WESLEY COMMUNITY CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLAINE BANDI (CEO)
(602) 368-9616
Entity
Organization
Contact information
Practice address
1510 S 19TH DR STE 100, PHOENIX, AZ 85009-6540
(602) 368-9896
Mailing address
1300 S 10TH ST, PHOENIX, AZ 85034-4516
(602) 368-9603
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QH0100X
Health Service Clinic/Center
—
—
Other
Enumeration date
01/22/2020
Last updated
04/09/2021
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