Organization
ADVANCED WELLNESS HOMES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OMAR IDIRIS (OWNER)
(507) 884-3032
Entity
Organization
Contact information
Practice address
2520 S PLAZA DR APT 3070, TEMPE, AZ 85282-1058
(507) 884-3032
Mailing address
2520 S PLAZA DR APT 3070, TEMPE, AZ 85282-1058
(507) 884-3032
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
07/07/2025
Last updated
07/07/2025
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