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Organization

BILLET BY ULU LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VAHAN OGANESYAN (COO)
(833) 224-5538
Entity
Organization

Contact information

Practice address
5540 W GLENDALE AVE STE C102, GLENDALE, AZ 85301-2581
(833) 224-5538
Mailing address
6710 N 47TH AVE, GLENDALE, AZ 85301-4121
(833) 224-5538

Taxonomy

Speciality
Code
Description
License number
State
202D00000X
Integrative Medicine Physician
Primary
207Q00000X
Family Medicine Physician
251B00000X
Case Management Agency
251S00000X
Community/Behavioral Health Agency
261QD0000X
Dental Clinic/Center
261QM0850X
Adult Mental Health Clinic/Center
343900000X
Non-emergency Medical Transport (VAN)

Other

Enumeration date
04/13/2023
Last updated
04/21/2023
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