Organization
GERIHEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAI SHANNON (CEO)
(480) 359-3998
Entity
Organization
Contact information
Practice address
3530 S VAL VISTA DR STE B210, GILBERT, AZ 85297-7318
(480) 359-3998
(480) 385-6785
Mailing address
3530 S VAL VISTA DR STE B210, GILBERT, AZ 85297-7318
(480) 359-3998
(480) 385-6785
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
10/30/2019
Last updated
10/30/2019
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