Organization
NUPHASE HEALTH SERVICES, LLC
Active
Organization
NUPHASE HEALTH SERVICES, LLC
Active
Other names
NuPhase Health Services
Organization subpart
No
Provider details
NPI number
Authorized official
MS. QIANA MICHELE MAYBERRY (CHIEF ADMINISTRATIVE OFFICER)
(717) 747-6522
Entity
Organization
Contact information
Practice address
4225 W GLENDALE AVE STE A102, PHOENIX, AZ 85051-8195
(717) 747-6522
Mailing address
14613 E DESERT VISTA TRL, SCOTTSDALE, AZ 85262-7826
(717) 747-6522
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164883
—
AZ
01
—
CSLG11865
AZ COUNSELING FACILITY LICENSE
AZ
Enumeration date
02/03/2022
Last updated
07/24/2023
Update your record
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