Healthcare Provider Details

I. General information

NPI: 1700664711
Provider Name (Legal Business Name): PJ HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2023
Last Update Date: 09/20/2023
Certification Date: 09/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14820 N CAVE CREEK RD STE 2
PHOENIX AZ
85032-4951
US

IV. Provider business mailing address

25716 N SANDSTONE WAY
SURPRISE AZ
85387-6839
US

V. Phone/Fax

Practice location:
  • Phone: 833-242-0100
  • Fax:
Mailing address:
  • Phone: 623-845-2528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name: PAOLA RIVERA
Title or Position: OWNER
Credential:
Phone: 623-845-2528