Organization
WEENDURE, INC.
Active
Organization
WEENDURE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUSTIN COLE EGNEW (CEO)
(760) 289-2153
Entity
Organization
Contact information
Practice address
3621 N TALL PINE LN, PINE, AZ 85544-5767
(760) 289-2153
Mailing address
PO BOX 792, PINE, AZ 85544-0792
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
—
—
251300000X
Local Education Agency (LEA)
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251V00000X
Voluntary or Charitable Agency
Primary
—
—
372600000X
Adult Companion
—
—
405300000X
Prevention Professional
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013557149
—
AZ
Enumeration date
10/05/2022
Last updated
10/05/2022
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