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General NPI Number Information
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NPI Number | 1518728039
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Entity Type | Organization
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Legal Business Name | ALMANAC HEALTH CARE GROUP LLC
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Dates
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Enumeration Date | 01/22/2024
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Last Update Date | 01/22/2024
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Provider Practice Location Address
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Address Line | 2 N CENTRAL AVE
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City | PHOENIX
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State | AZ
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Zip | 85004-2322
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Country | US
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Telephone | 214-892-1584
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Fax | 833-740-4242
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Provider Business Mailing Address
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Address Line | 4053 KYNDRA CIR
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City | RICHARDSON
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State | TX
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Zip | 75082-2762
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Country | US
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Telephone | 951-545-1482
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Fax | 833-740-4242
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. ADAEZE ILO
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Credential | PMHNP
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Telephone | 214-892-1584
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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