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General NPI Number Information
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NPI Number | 1699324772
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Entity Type | Organization
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Legal Business Name | PURPOSE HEALING CENTER, LLC
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Dates
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Enumeration Date | 09/10/2019
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Last Update Date | 11/05/2021
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Provider Practice Location Address
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Address Line | 6885 E PINNACLE VISTA DR
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City | SCOTTSDALE
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State | AZ
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Zip | 85266-8739
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Country | US
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Telephone | 480-579-3319
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Fax |
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Provider Business Mailing Address
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Address Line | 9332 N 95TH WAY STE B203
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-5513
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | GABRIEL TOMAENO
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Credential |
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Telephone | 480-267-8491
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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