MEDICARE: NINA J WORKS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320800000X	Mental Illness Community Based Residential Treatment Facility	BHRF20078	AZ

General Provider Information

NPI Number	:	1437025624
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NINA J WORKS

Provider Business Mailing Address
First Line	:	6205 S 44TH DR
Second Line	:
City	:	LAVEEN
State	:	AZ
Zip	:	85339-1961
Country	:	US
Telephone Number	:	602-670-0665
Fax Number	:

Provider Business Practice Location Address
First Line	:	2718 W PECAN RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85041-4419
Country	:	US
Telephone Number	:	602-670-0665
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/14/2025
Last Update Date	:	10/14/2025

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Directions to “ NINA J WORKS ” Practice Location

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