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Individual

MR. EMMANUEL ADE EPIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
7204 W PUEBLO AVE, PHOENIX, AZ 85043-2037
(623) 440-7423
Mailing address
1638 E GREENWAY RD, PHOENIX, AZ 85042-5788
(602) 481-9789
(602) 268-1248

Taxonomy

Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
BH3872
AZ
323P00000X
Psychiatric Residential Treatment Facility
AZ
323P00000X
Psychiatric Residential Treatment Facility

Other

Enumeration date
08/02/2011
Last updated
09/30/2019
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