Healthcare Provider Details

I. General information

NPI: 1821542077
Provider Name (Legal Business Name): CRISIS PREGNANCY CENTERS OF GREATER PHOENIX
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2016
Last Update Date: 08/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10555 N 58TH DR
GLENDALE AZ
85302-1360
US

IV. Provider business mailing address

10555 N 58TH DR
GLENDALE AZ
85302-1360
US

V. Phone/Fax

Practice location:
  • Phone: 623-486-5232
  • Fax: 623-486-4355
Mailing address:
  • Phone: 623-486-5232
  • Fax: 623-486-4355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. RAUL REYES
Title or Position: PRESIDENT
Credential:
Phone: 602-508-3350