Organization
SMILING SPIRITS
Active
Parent organization
SMILING SPIRITS LLC
Other names
Smiling Spirits Generations
Organization subpart
Yes
Provider details
NPI number
Legal business name
SMILING SPIRITS LLC
Authorized official
RAMON WEAVER (ADMINISTRATOR)
(480) 504-2676
Entity
Organization
Contact information
Practice address
1001 E WARNER RD STE 104, TEMPE, AZ 85284-3224
(480) 504-2676
Mailing address
1007 E WARNER RD STE 110, TEMPE, AZ 85284-3242
(480) 504-2676
(480) 504-2719
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13371
LICENSE
AZ
05
—
189006
—
AZ
Enumeration date
03/12/2024
Last updated
06/15/2024
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