Organization
US VETS-ARIZONA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE JAMESON (EXECUTIVE DIRECTOR)
(602) 501-5548
Entity
Organization
Contact information
Practice address
3400 GRAND AVE, PHOENIX, AZ 85017-4507
(602) 739-2552
Mailing address
3507 N CENTRAL AVE, PHOENIX, AZ 85012-2118
(602) 501-5548
(602) 441-0613
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LISAC-11703
AZ
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
07/24/2018
Last updated
07/24/2018
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