Healthcare Provider Details

I. General information

NPI: 1528650694
Provider Name (Legal Business Name): HEALING HUMANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2021
Last Update Date: 02/09/2021
Certification Date: 02/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6520 N 7TH ST STE 100
PHOENIX AZ
85014-1213
US

IV. Provider business mailing address

6520 N 7TH ST STE 100
PHOENIX AZ
85014-1213
US

V. Phone/Fax

Practice location:
  • Phone: 480-681-0454
  • Fax: 480-681-0449
Mailing address:
  • Phone: 480-681-0454
  • Fax: 480-681-0449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MATTHEW EVANS
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 480-681-0454