Organization
E&G OUTPATIENT CENTER LLC
Active
Other names
E&G OUTPATIENT CENTER LLC
Organization subpart
No
Provider details
NPI number
Authorized official
GISELE KAYITESI (ADMINISTRATOR)
(614) 818-8442
Entity
Organization
Contact information
Practice address
3802 N 53RD AVE STE 280, PHOENIX, AZ 85031-3021
(614) 818-8442
Mailing address
5224 W SIESTA WAY, LAVEEN, AZ 85339-7178
(614) 818-8442
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
—
—
Other
Enumeration date
06/02/2023
Last updated
06/02/2023
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