Organization
NAMASTASOBER
Active
Organization
NAMASTASOBER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA L ELIZONDO (CEO)
(480) 593-5878
Entity
Organization
Contact information
Practice address
3707 E SOUTHERN AVE # 20922094, MESA, AZ 85206-2569
(480) 593-5878
Mailing address
3707 E SOUTHERN AVE, MESA, AZ 85206-2569
(480) 593-5878
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
—
—
Other
Enumeration date
11/18/2022
Last updated
11/18/2022
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