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General NPI Number Information
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NPI Number | 1588467583
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Entity Type | Organization
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Legal Business Name | ESSENTIAL CARE AND COUNSELING CENTER
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Dates
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Enumeration Date | 03/27/2025
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 7802 N 43RD AVE STE 5
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City | GLENDALE
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State | AZ
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Zip | 85301-8111
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Country | US
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Telephone | 480-386-1212
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Fax |
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Provider Business Mailing Address
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Address Line | 7802 N 43RD AVE STE 5
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City | GLENDALE
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State | AZ
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Zip | 85301-8111
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Country | US
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Telephone | 480-386-1212
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CODY VICARIO
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Credential |
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Telephone | 623-215-1212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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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 | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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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 | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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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 | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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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 | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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