Healthcare Provider Details

I. General information

NPI: 1922705912
Provider Name (Legal Business Name): WEMA HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2023
Last Update Date: 02/10/2023
Certification Date: 02/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31235 N SUNDOWN DR
SAN TAN VALLEY AZ
85143-3241
US

IV. Provider business mailing address

31235 N SUNDOWN DR
SAN TAN VALLEY AZ
85143-3241
US

V. Phone/Fax

Practice location:
  • Phone: 480-336-2102
  • Fax: 480-297-0918
Mailing address:
  • Phone: 480-336-2102
  • Fax: 480-297-0918

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code276400000X
TaxonomySubstance Use Disorder Rehabilitation Hospital Unit
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: AMOS WAMWEYA
Title or Position: HOUSE MANAGER
Credential:
Phone: 480-336-2102