Individual
SAB EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CNA
Contact information
Practice address
15639 N VERDE ST, SURPRISE, AZ 85378-4168
(623) 248-4100
Mailing address
4811 N 96TH LN, PHOENIX, AZ 85037-1063
(623) 248-4100
(623) 248-1534
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
SLH10671
AZ
251S00000X
Community/Behavioral Health Agency
Primary
SLH10671
AZ
253J00000X
Foster Care Agency
SLH10671
AZ
347C00000X
Private Vehicle
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
132133
—
AZ
Enumeration date
06/09/2023
Last updated
02/28/2024
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