Organization
CENTER STREET
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NILAH EMAGE ASY JAMIE QUINONES (OWNER)
(323) 316-7585
Entity
Organization
Contact information
Practice address
5949 W NORTHERN AVE STE 201, GLENDALE, AZ 85301-7829
(323) 233-1675
Mailing address
2739 W RANCHO DR, PHOENIX, AZ 85017-2645
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
10/14/2022
Last updated
10/18/2022
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