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General NPI Number Information
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NPI Number | 1326857202
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Entity Type | Organization
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Legal Business Name | RENE'S CARE FACILITY LLC
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Dates
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Enumeration Date | 01/06/2025
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Last Update Date | 08/19/2025
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Provider Practice Location Address
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Address Line | 3231 W. THUNDERBIRD RD
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City | PHOENIX
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State | AZ
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Zip | 85053
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Country | US
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Telephone | 623-666-1904
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Fax |
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Provider Business Mailing Address
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Address Line | 4040 E MCDOWELL RD
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City | PHOENIX
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State | AZ
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Zip | 85008-4414
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | IGOR GADAEV
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Credential |
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Telephone | 623-666-1904
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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