Healthcare Provider Details

I. General information

NPI: 1588521348
Provider Name (Legal Business Name): MR. GRAECEN JAMES LEE-FURCINI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2026
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 S HIGLEY RD STE 201
MESA AZ
85206-4002
US

IV. Provider business mailing address

19 W CONCORDA DR APT 103
TEMPE AZ
85282-3535
US

V. Phone/Fax

Practice location:
  • Phone: 844-646-3247
  • Fax:
Mailing address:
  • Phone: 602-696-1428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: