Organization
SMALL VICTORIES WELLNESS CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHEL CHINGAYA (CEO)
(469) 774-9159
Entity
Organization
Contact information
Practice address
15640 N 7TH ST BLDG B, PHOENIX, AZ 85022-3512
(469) 774-9195
Mailing address
15640 N 7TH ST BLDG B, PHOENIX, AZ 85022-3512
(469) 774-9195
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QC1500X
Community Health Clinic/Center
—
—
Other
Enumeration date
03/06/2023
Last updated
03/06/2023
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