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General NPI Number Information
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NPI Number | 1144799792
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Entity Type | Organization
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Legal Business Name | GENHEALTH
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Dates
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Enumeration Date | 11/13/2018
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 14441 W MCDOWELL RD STE B102
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City | GOODYEAR
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State | AZ
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Zip | 85395-2519
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Country | US
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Telephone | 480-516-8037
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Fax | 480-400-4383
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Provider Business Mailing Address
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Address Line | 14441 W MCDOWELL RD STE B102
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City | GOODYEAR
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State | AZ
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Zip | 85395-2519
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Country | US
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Telephone | 480-516-8037
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Fax | 480-400-4383
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Authorized Official
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Title or Position | CEO
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Name | DAVID ROSS
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Credential | PHARMD
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Telephone | 480-559-5260
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | 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 | 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 #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number |
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Taxonomy #5
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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Taxonomy #6
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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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 | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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License Number |
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Taxonomy #8
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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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 | 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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Taxonomy #10
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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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 | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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Taxonomy #12
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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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Taxonomy #13
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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