Organization
THUNDERMAKER WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADDISON HOWARD (ADMINISTRATIVE OFFICER)
(928) 531-1930
Entity
Organization
Contact information
Practice address
1045 WHIPPLE ST, PRESCOTT, AZ 86305-1662
(928) 493-4300
Mailing address
1045 WHIPPLE ST, PRESCOTT, AZ 86305-1662
(928) 493-4300
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
03/04/2025
Last updated
12/12/2025
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