Organization
GREATER PHOENIX COLLABORATIVE CARE PC
Active
Parent organization
GREATER PHOENIX COLLABORATIVE CARE PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
GREATER PHOENIX COLLABORATIVE CARE PC
Authorized official
EMILY CASTILLO (REGIONAL MANAGER)
(702) 480-2550
Entity
Organization
Contact information
Practice address
8041 N BLACK CANYON HWY, PHOENIX, AZ 85021-4876
(602) 249-0115
Mailing address
PO BOX 35380, MEDICAL STAFF- CREDENTIALING DEPT., LAS VEGAS, NV 89133-5380
(702) 579-3253
(702) 304-7451
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
OTC 4998
AZ
Other
Enumeration date
01/24/2011
Last updated
05/30/2024
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