Healthcare Provider Details

I. General information

NPI: 1376337774
Provider Name (Legal Business Name): ALIUM HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2025
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2242 W SOUTHERN AVE
MESA AZ
85202-4704
US

IV. Provider business mailing address

7425 E SHEA BLVD STE 107
SCOTTSDALE AZ
85260-6411
US

V. Phone/Fax

Practice location:
  • Phone: 480-750-0095
  • Fax:
Mailing address:
  • Phone: 480-750-0095
  • Fax: 480-750-0095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANDREW ELLIOTT
Title or Position: CEO
Credential:
Phone: 323-369-0069