Organization
COLLECTIVE CARE HEALTH NETWORK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DESIREE WILSON (OWNER)
(480) 331-6228
Entity
Organization
Contact information
Practice address
630 W 17TH PL, TEMPE, AZ 85281-6519
(480) 331-6228
Mailing address
3409 N 7TH AVE UNIT 2018, PHOENIX, AZ 85013-3635
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
06/27/2022
Last updated
03/30/2026
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