Healthcare Provider Details

I. General information

NPI: 1083594642
Provider Name (Legal Business Name): ARIZONA PHYSICIANS GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2025
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16872 E AVENUE OF THE FOUNTAINS STE 203
FOUNTAIN HILLS AZ
85268-8314
US

IV. Provider business mailing address

16872 E AVENUE OF THE FOUNTAINS STE 203
FOUNTAIN HILLS AZ
85268-8314
US

V. Phone/Fax

Practice location:
  • Phone: 800-715-2004
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHARISE PALMROTH
Title or Position: MA
Credential:
Phone: 480-476-8900