Healthcare Provider Details

I. General information

NPI: 1972477248
Provider Name (Legal Business Name): PROJECT NEW GEN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2025
Last Update Date: 01/14/2026
Certification Date: 01/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4444 W NORTHERN AVE STE B1
GLENDALE AZ
85301-1687
US

IV. Provider business mailing address

4444 W NORTHERN AVE STE B1
GLENDALE AZ
85301-1687
US

V. Phone/Fax

Practice location:
  • Phone: 480-729-9294
  • Fax:
Mailing address:
  • Phone: 602-391-5038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GEORGE GUERRERO
Title or Position: MANAGER
Credential:
Phone: 602-391-5038