Organization
ANI-G WELLNESS RESIDENCY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KWAME KONNOR PHARMD (ADMINISTRATOR)
(480) 287-2931
Entity
Organization
Contact information
Practice address
20278 N WILFORD AVE, MARICOPA, AZ 85138-6781
(480) 228-4001
Mailing address
20278 N WILFORD AVE, MARICOPA, AZ 85138-6781
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/11/2023
Last updated
05/18/2023
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