Healthcare Provider Details

I. General information

NPI: 1194196337
Provider Name (Legal Business Name): ZAREPHATH INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2015
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2060 E 37TH AVE
APACHE JUNCTION AZ
85119-3638
US

IV. Provider business mailing address

4856 E. BASELINE ROAD SUITE 104
MESA AZ
85206-4635
US

V. Phone/Fax

Practice location:
  • Phone: 480-518-6826
  • Fax: 480-361-9144
Mailing address:
  • Phone: 480-518-6826
  • Fax: 480-361-9144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385HR2055X
TaxonomyChild Mental Illness Respite Care
License NumberBH4725
License Number StateAZ

VIII. Authorized Official

Name: SIMCHA FELLER
Title or Position: C.E.O.
Credential:
Phone: 347-668-0449