Healthcare Provider Details

I. General information

NPI: 1528415650
Provider Name (Legal Business Name): NAZCARE, INC. - EATON CENTER FOR JOYFUL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2016
Last Update Date: 07/01/2021
Certification Date: 07/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8128 E STATE ROUTE 69 STE 201
PRESCOTT VALLEY AZ
86314-9459
US

IV. Provider business mailing address

599 WHITE SPAR RD
PRESCOTT AZ
86303-4627
US

V. Phone/Fax

Practice location:
  • Phone: 928-442-9205
  • Fax: 602-535-3230
Mailing address:
  • Phone: 928-442-9205
  • Fax: 602-535-3230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License NumberCSA 14ADHS014813
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCSLG7699
License Number StateAZ

VIII. Authorized Official

Name: GREG BILLI
Title or Position: CEO
Credential:
Phone: 928-442-9205