Organization
ELITE INNOVATIVE HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM RICHARDSON (MANAGING PARTNER)
(708) 595-0973
Entity
Organization
Contact information
Practice address
325 E BASELINE RD, GILBERT, AZ 85233-1102
(708) 595-0973
Mailing address
325 E BASELINE RD, GILBERT, AZ 85233-1102
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
06/28/2021
Last updated
06/28/2021
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