Organization
SALOSAA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA OWENS (OWNER)
(480) 468-1796
Entity
Organization
Contact information
Practice address
5060 N 19TH AVE STE 411, PHOENIX, AZ 85015-3214
(480) 468-1796
Mailing address
11835 N 19TH AVE, PHOENIX, AZ 85029-3523
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/21/2021
Last updated
05/24/2021
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