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General NPI Number Information
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NPI Number | 1356020036
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Entity Type | Organization
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Legal Business Name | CTEN HEALTH & WELLNESS LLC
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Dates
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Enumeration Date | 07/12/2023
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Last Update Date | 07/12/2023
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Provider Practice Location Address
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Address Line | 6534 W GEORGETOWN WAY
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City | FLORENCE
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State | AZ
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Zip | 85132-5668
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Country | US
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Telephone | 520-424-6826
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Fax |
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Provider Business Mailing Address
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Address Line | 1578 E SILVER REEF DR
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City | CASA GRANDE
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State | AZ
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Zip | 85122-6424
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Country | US
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Telephone | 520-424-6826
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | ELONNA OKUAGU
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Credential |
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Telephone | 520-424-6826
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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