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General NPI Number Information
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NPI Number | 1336811447
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Entity Type | Organization
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Legal Business Name | ARIZONA PREMIUM CARE LLC
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Dates
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Enumeration Date | 09/28/2021
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Last Update Date | 09/28/2021
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Provider Practice Location Address
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Address Line | 3255 S DORSEY LN APT 2097
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City | TEMPE
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State | AZ
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Zip | 85282-3987
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Country | US
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Telephone | 480-721-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 3255 S DORSEY LN APT 2097
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City | TEMPE
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State | AZ
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Zip | 85282-3987
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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 | DIRECTOR
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Name | SULAFA SALIM
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Credential |
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Telephone | 480-721-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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