Organization
MIDDLEGROUND WELLNESS CENTER LLC
Active
Organization
MIDDLEGROUND WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN KABATA (OWNER)
(480) 277-8167
Entity
Organization
Contact information
Practice address
1660 S ALMA SCHOOL RD STE 21, MESA, AZ 85210-3069
(480) 277-8167
Mailing address
1660 S ALMA SCHOOL RD STE 21, MESA, AZ 85210-3069
(480) 277-8167
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
—
—
Other
Enumeration date
09/19/2022
Last updated
09/19/2022
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