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General NPI Number Information
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NPI Number | 1689414153
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Entity Type | Organization
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Legal Business Name | GENEVA MIND & WELLNESS PSYCHIATRIC SERVICES LLC
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Dates
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Enumeration Date | 05/30/2024
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 4579 N VILLAGE PKWY
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City | LITCHFIELD PARK
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State | AZ
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Zip | 85340-2761
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Country | US
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Telephone | 623-760-6381
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Fax | 623-322-3268
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Provider Business Mailing Address
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Address Line | 4579 N VILLAGE PKWY
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City | LITCHFIELD PARK
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State | AZ
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Zip | 85340-2761
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Country | US
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Telephone | 623-760-6381
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Fax | 623-322-3268
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Authorized Official
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Title or Position | PMHNP
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Name | GENEVIEVE IJEOMA ONYIRIMBA
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Credential | NP
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Telephone | 623-760-6381
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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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