Healthcare Provider Details

I. General information

NPI: 1669281416
Provider Name (Legal Business Name): RICHARDS AND KIM GROUP CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2025
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6613 N SCOTTSDALE RD STE 101
SCOTTSDALE AZ
85250-7800
US

IV. Provider business mailing address

5701 W CHOLLA ST
GLENDALE AZ
85304-3337
US

V. Phone/Fax

Practice location:
  • Phone: 833-568-0473
  • Fax:
Mailing address:
  • Phone: 562-822-2772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHO LONG KIM
Title or Position: PRESIDENT
Credential: NMD, PMHNP-BC
Phone: 562-822-2772