MEDICARE: JORGE TORRES

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	103K00000X	Behavior Analyst		AZ

General Provider Information

NPI Number	:	1639883226
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORGE TORRES

Provider Business Mailing Address
First Line	:	27777 INKSTER RD STE 100
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-5312
Country	:	US
Telephone Number	:	557-728-8478
Fax Number	:

Provider Business Practice Location Address
First Line	:	3310 N 19TH AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85015-5701
Country	:	US
Telephone Number	:	855-772-8847
Fax Number	:	248-621-3830

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

Provider Enumeration Date	:	01/09/2023
Last Update Date	:	02/10/2026

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Directions to “ JORGE TORRES ” Practice Location

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