Organization
GUIDED MED SPA
Active
Organization
GUIDED MED SPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SEMI ANTHONY (CEO)
(626) 376-2975
Entity
Organization
Contact information
Practice address
3820 N 3RD ST, PHOENIX, AZ 85012-2022
(623) 594-6097
(623) 594-6960
Mailing address
3820 N 3RD ST, PHOENIX, AZ 85012-2022
(623) 594-6097
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
—
—
261QI0500X
Infusion Therapy Clinic/Center
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
Other
Enumeration date
08/24/2023
Last updated
08/24/2023
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