Healthcare Provider Details

I. General information

NPI: 1720941164
Provider Name (Legal Business Name): REFUGE MENTAL WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13234 W BERRIDGE LN
LITCHFIELD PARK AZ
85340-7308
US

IV. Provider business mailing address

13234 W BERRIDGE LN
LITCHFIELD PARK AZ
85340-7308
US

V. Phone/Fax

Practice location:
  • Phone: 602-657-8462
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY DENHAM
Title or Position: AGENT
Credential: PMHNP
Phone: 602-657-8462