Healthcare Provider Details

I. General information

NPI: 1295160380
Provider Name (Legal Business Name): JOURNEY TO PROSPERITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2013
Last Update Date: 05/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1623 W DENTON
PHOENIX AZ
85015
US

IV. Provider business mailing address

PO BOX 33171
PHOENIX AZ
85067
US

V. Phone/Fax

Practice location:
  • Phone: 602-726-5057
  • Fax:
Mailing address:
  • Phone: 602-726-5057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: ANIISHA SARKISSIAN
Title or Position: C.E.O
Credential:
Phone: 602-726-5057