Healthcare Provider Details

I. General information

NPI: 1063366557
Provider Name (Legal Business Name): SENIOR SAFETY ASSESSMENT GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2026
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 E BELMONT AVE
PHOENIX AZ
85020-4017
US

IV. Provider business mailing address

4539 N 22ND ST # 4880
PHOENIX AZ
85016-4639
US

V. Phone/Fax

Practice location:
  • Phone: 480-447-2086
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DESARIE WALWYN
Title or Position: OWNER/LEAD SOCIAL WORKER
Credential: LMSW
Phone: 480-447-2086