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General NPI Number Information
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NPI Number | 1336952308
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Entity Type | Organization
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Legal Business Name | PROSANO HEALTH SOLUTIONS, INC.
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Dates
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Enumeration Date | 01/31/2025
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 1360 N BULLARD AVE STE 102
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City | GOODYEAR
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State | AZ
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Zip | 85395-2744
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Country | US
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Telephone | 855-776-7266
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Fax | 602-336-7675
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Provider Business Mailing Address
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Address Line | 8220 N 23RD AVE
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City | PHOENIX
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State | AZ
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Zip | 85021-4872
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Country | US
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Telephone | 855-776-7266
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | AARON BOWEN
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Credential |
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Telephone | 480-493-7249
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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