Organization
SOUL SURGERY SILKWORTH CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REGINA SHAKESPEARE (BILLING COMPLIANCE OFFICER)
(928) 554-5633
Entity
Organization
Contact information
Practice address
16433 N 68TH PL, SCOTTSDALE, AZ 85254-1500
(480) 912-3105
(480) 477-7894
Mailing address
PO BOX 12434, SCOTTSDALE, AZ 85267-2434
(480) 912-3105
(480) 912-3106
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
01/31/2020
Last updated
01/31/2020
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