Healthcare Provider Details

I. General information

NPI: 1508730409
Provider Name (Legal Business Name): MEDICAL BILLING RESOURCES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2025
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6742 W PALMAIRE AVE APT 2
GLENDALE AZ
85303-2603
US

IV. Provider business mailing address

6742 W PALMAIRE AVE APT 2
GLENDALE AZ
85303-2603
US

V. Phone/Fax

Practice location:
  • Phone: 480-995-8364
  • Fax:
Mailing address:
  • Phone: 480-995-8364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MARIA YOLANDA IBARRA
Title or Position: TREASURER
Credential:
Phone: 480-995-8364