Organization
WELLSPRINGS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICKY BEN (MEMBER)
(928) 679-5408
Entity
Organization
Contact information
Practice address
1/4 MILE SOUTH OF WHIPPOORWELL CHAPTER HOUSE, BLUE GAP, AZ 86520
(928) 679-5408
Mailing address
PO BOX 4493, BLUE GAP, AZ 86520-4493
(928) 679-5408
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
05/12/2022
Last updated
05/12/2022
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