Healthcare Provider Details

I. General information

NPI: 1447081385
Provider Name (Legal Business Name): TERROS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2024
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3540 E BASELINE RD STE 150
PHOENIX AZ
85042-9630
US

IV. Provider business mailing address

3003 N CENTRAL AVE STE 400
PHOENIX AZ
85012-2929
US

V. Phone/Fax

Practice location:
  • Phone: 602-685-6000
  • Fax: 602-302-7925
Mailing address:
  • Phone: 602-685-6000
  • Fax: 602-302-7925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0800X
TaxonomyRecovery Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: KAREN HOFFMAN TEPPER
Title or Position: PRESIDENT/CEO
Credential: PHD
Phone: 602-685-6000