Organization
SOUL SURGERY WILSON SMITH CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL GOLDENBERG (ADMINISTRATOR)
(480) 912-3105
Entity
Organization
Contact information
Practice address
12816 E TURQUOISE AVE, SCOTTSDALE, AZ 85259-5300
(480) 912-3105
(480) 477-7894
Mailing address
PO BOX 12434, SCOTTSDALE, AZ 85267-2434
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
06/05/2023
Last updated
06/05/2023
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