Healthcare Provider Details

I. General information

NPI: 1386454098
Provider Name (Legal Business Name): TERI'S HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2025
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14040 N CAVE CREEK RD STE 104
PHOENIX AZ
85022-6117
US

IV. Provider business mailing address

6635 W HAPPY VALLEY RD STE A104-621
GLENDALE AZ
85310-2609
US

V. Phone/Fax

Practice location:
  • Phone: 602-358-7073
  • Fax: 602-429-8602
Mailing address:
  • Phone: 602-503-0710
  • Fax: 602-358-7073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PENNY SWING
Title or Position: CREDENTIALING
Credential:
Phone: 928-318-3835