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General NPI Number Information
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NPI Number | 1366137630
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Entity Type | Organization
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Legal Business Name | NEW ALTERNATIVE ZONE LLC
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Dates
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Enumeration Date | 04/11/2023
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Last Update Date | 04/11/2023
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Provider Practice Location Address
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Address Line | 10045 E DYNAMITE BLVD STE 230
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City | SCOTTSDALE
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State | AZ
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Zip | 85262-3751
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Country | US
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Telephone | 480-550-5924
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Fax |
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Provider Business Mailing Address
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Address Line | 10045 E DYNAMITE BLVD STE 230
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City | SCOTTSDALE
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State | AZ
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Zip | 85262-3751
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Country | US
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Telephone | 480-550-5924
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | QUINTIN SLAUGHTER
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Credential |
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Telephone | 480-550-5924
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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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