Organization
UPC-PHXMEM-CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIXIE LOVRIEN (CREDENTIALING MANAGER)
(602) 253-5100
Entity
Organization
Contact information
Practice address
1201 S 7TH AVE STE 150, PHOENIX, AZ 85007-4075
(602) 253-5100
(866) 882-5456
Mailing address
1201 S 7TH AVE STE 150, PHOENIX, AZ 85007-4075
(602) 253-5100
(866) 882-5456
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
06/16/2015
Last updated
06/16/2015
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