Healthcare Provider Details

I. General information

NPI: 1902597016
Provider Name (Legal Business Name): SIMPLY STIERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2023
Last Update Date: 05/18/2023
Certification Date: 05/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 N SAGUARO DR LOT F4
APACHE JUNCTION AZ
85120-3705
US

IV. Provider business mailing address

275 N SAGUARO DR LOT F4 275 N SAGUARO DR. LOT F4
APACHE JUNCTION AZ
85120
US

V. Phone/Fax

Practice location:
  • Phone: 480-909-8490
  • Fax:
Mailing address:
  • Phone: 480-909-8490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: PRISCILLA M MARTINEZ
Title or Position: OWNER
Credential:
Phone: 480-909-8490