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General NPI Number Information
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NPI Number | 1295582344
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Entity Type | Organization
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Legal Business Name | AMICUS HEALTH AND WELLNESS LLC
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Dates
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Enumeration Date | 05/06/2024
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | 2111 E BASELINE RD STE C8
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City | TEMPE
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State | AZ
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Zip | 85283-1521
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Country | US
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Telephone | 480-809-1765
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Fax |
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Provider Business Mailing Address
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Address Line | 2111 E BASELINE RD STE C8
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City | TEMPE
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State | AZ
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Zip | 85283-1521
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Country | US
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Telephone | 480-809-1765
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Fax | 480-602-4406
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Authorized Official
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Title or Position | CEO
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Name | MR. SALEH BAHATI
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Credential | PMHNP-BC, MPH, CPH
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Telephone | 480-809-1765
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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