Healthcare Provider Details
I. General information
NPI: 1497241079
Provider Name (Legal Business Name): SAGUARO TREATMENT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/06/2018
Last Update Date: 07/20/2021
Certification Date: 07/20/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5533 E. BELL RD #111
SCOTTSDALE AZ
85254
US
IV. Provider business mailing address
5533 E. BELL RD SUITE 111
SCOTTSDALE AZ
85254
US
V. Phone/Fax
- Phone: 602-334-1080
- Fax: 602-788-4208
- Phone: 602-334-1080
- Fax: 602-788-4208
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
JUSTIN
P.
PIERCE
Title or Position: OWNER
Credential: D.C.
Phone: 602-334-1080