Healthcare Provider Details

I. General information

NPI: 1902583966
Provider Name (Legal Business Name): BEST CARE WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2023
Last Update Date: 06/30/2023
Certification Date: 06/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 W HATCHER RD STE 104
PHOENIX AZ
85021-2491
US

IV. Provider business mailing address

321 W HATCHER RD STE 206
PHOENIX AZ
85021-2493
US

V. Phone/Fax

Practice location:
  • Phone: 602-675-1686
  • Fax: 602-675-1703
Mailing address:
  • Phone: 602-675-1686
  • Fax: 602-675-1703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. KAY BODUDE
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 816-456-6860