Healthcare Provider Details

I. General information

NPI: 1083573232
Provider Name (Legal Business Name): QUAIL SPIRIT WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2026
Last Update Date: 01/21/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4539 N 22ND ST STE A
PHOENIX AZ
85016-4639
US

IV. Provider business mailing address

4539 N 22ND ST STE A
PHOENIX AZ
85016-4639
US

V. Phone/Fax

Practice location:
  • Phone: 520-334-1150
  • Fax:
Mailing address:
  • Phone: 520-334-1150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: LYNDSEY HROMATKA
Title or Position: SOCIAL WORKER
Credential: LCSW
Phone: 520-230-2241