Organization
MOMM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANOZZLE WRIGHT (AUTHORIZED AGENT)
(602) 803-2065
Entity
Organization
Contact information
Practice address
2822 N 32ND ST, PHOENIX, AZ 85008-1261
(602) 803-2065
Mailing address
2822 N 32ND ST, PHOENIX, AZ 85008-1261
(602) 803-2065
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
03/20/2023
Last updated
03/20/2023
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