Organization
MANA HEALTH & WELLNESS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON FOUNTAIN (PRESIDENT)
(808) 306-3054
Entity
Organization
Contact information
Practice address
4550 N BLACK CANYON HWY, PHOENIX, AZ 85017-3714
(808) 306-3054
Mailing address
4550 N BLACK CANYON HWY, PHOENIX, AZ 85017-3714
(808) 306-3054
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
363L00000X
Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
05/29/2023
Last updated
05/13/2025
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