Healthcare Provider Details

I. General information

NPI: 1417738014
Provider Name (Legal Business Name): NAZCARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2023
Last Update Date: 10/10/2023
Certification Date: 09/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

846 W COTTONWOOD LN
CASA GRANDE AZ
85122-2223
US

IV. Provider business mailing address

8128 E STATE ROUTE 69 STE 201
PRESCOTT VALLEY AZ
86314-9459
US

V. Phone/Fax

Practice location:
  • Phone: 928-442-9205
  • Fax: 602-535-3230
Mailing address:
  • Phone: 928-442-9205
  • Fax: 602-535-3230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: KAREN MOCK
Title or Position: CLAIMS SUPERVISOR
Credential:
Phone: 928-442-9205