Healthcare Provider Details

I. General information

NPI: 1780546374
Provider Name (Legal Business Name): IRISCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15380 W FILLMORE ST APT 3039
GOODYEAR AZ
85338-4679
US

IV. Provider business mailing address

15380 W FILLMORE ST APT 3039
GOODYEAR AZ
85338-4679
US

V. Phone/Fax

Practice location:
  • Phone: 602-726-5759
  • Fax:
Mailing address:
  • Phone: 602-726-5759
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: KENDRA ROBINSON
Title or Position: CEO
Credential:
Phone: 714-328-8260