Organization
OBSIDIAN HEALTH AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER FLACK LCSW (DIRECTOR OF CLINICAL SERVICES)
(720) 331-1168
Entity
Organization
Contact information
Practice address
13321 W INDIAN SCHOOL RD, LITCHFIELD PARK, AZ 85340-4339
(000) 000-0000
Mailing address
13321 W INDIAN SCHOOL RD STE A107, LITCHFIELD PARK, AZ 85340-4339
(602) 550-7844
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
07/17/2018
Last updated
09/28/2018
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