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General NPI Number Information
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NPI Number | 1003525312
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Entity Type | Organization
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Legal Business Name | NATIVE COUNTRY HEALTHCARE SYSTEMS
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Dates
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Enumeration Date | 11/16/2022
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Last Update Date | 11/16/2022
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Provider Practice Location Address
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Address Line | 4805 W THOMAS RD
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City | PHOENIX
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State | AZ
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Zip | 85031-4050
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Country | US
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Telephone | 602-706-8741
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Fax |
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Provider Business Mailing Address
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Address Line | 4805 W THOMAS RD
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City | PHOENIX
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State | AZ
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Zip | 85031-4050
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Country | US
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Telephone | 602-706-8741
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PROF. UGORJI WILSON ONYEANI
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Credential | RN,MD
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Telephone | 602-922-6182
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 261QM2800X
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Taxonomy Name | Methadone Clinic
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number |
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License Number State |
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Taxonomy #15
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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