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Organization

ELEVATE ARIZONA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. WALTER NEIL SIMMONS MD, MPH, FACEP (CHIEF MEDICAL OFFICER)
(480) 428-8022
Entity
Organization

Contact information

Practice address
3208 N LADERA CIR, MESA, AZ 85207-0810
(480) 428-8022
Mailing address
3208 N LADERA CIR, MESA, AZ 85207-0810
(480) 428-8022

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
101YA0400X
Addiction (Substance Use Disorder) Counselor
103TA0400X
Addiction (Substance Use Disorder) Psychologist
104100000X
Social Worker

Other

Enumeration date
10/24/2014
Last updated
10/24/2014
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