Organization
SUPREME POSITIVE INNOVATION SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATELYN MARIE TAMAS (MANAGING PARTNER)
(602) 757-6786
Entity
Organization
Contact information
Practice address
1833 W MAIN ST STE 139-140, MESA, AZ 85201-6922
(602) 757-6786
Mailing address
1833 W MAIN ST STE 139-140, MESA, AZ 85201-6922
(602) 757-6786
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
09/26/2020
Last updated
09/28/2020
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