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General NPI Number Information
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NPI Number | 1154168748
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Entity Type | Organization
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Legal Business Name | FIREBIRD HEALTHCARE SERVICES LLC
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Dates
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Enumeration Date | 07/10/2024
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 7638 W ARTEMISA AVE
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City | PEORIA
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State | AZ
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Zip | 85383-1922
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Country | US
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Telephone | 480-526-1065
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Fax |
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Provider Business Mailing Address
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Address Line | 7638 W ARTEMISA AVE
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City | PEORIA
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State | AZ
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Zip | 85383-1922
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Country | US
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Telephone | 480-526-1065
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KARL REINHARDT HAUKENFRERS
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Credential |
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Telephone | 480-526-1065
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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