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NPI Code Detail

MEDICARE: TERROS, INC.

MEDICARE: TERROS, INC.
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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)OTC-5659AZ
2261QP2300XPrimary Care Clinic/CenterOTC-5659AZ
3261QF0400XFederally Qualified Health Center (FQHC)LAL000166AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1699173245
Entity Type Code : Organization
Provider Name (Legal Business Name) : TERROS, INC.
Provider Business Mailing Address
First Line : 3003 N CENTRAL AVE STE 400
Second Line :
City : PHOENIX
State : AZ
Zip : 85012-2929
Country : US
Telephone Number : 602-685-6000
Fax Number : 602-302-7925
Provider Business Practice Location Address
First Line : 6151-6153 W OLIVE AVE
Second Line :
City : GLENDALE
State : AZ
Zip : 85302-4598
Country : US
Telephone Number : 602-685-6000
Fax Number : 623-937-2589
Authorized Official
Title or Position : PRESIDENT & CEO
Name : MRS. KAREN HOFFMAN TEPPER
Credential : PH.D
Telephone Number : 602-685-6000
Provider Enumeration Date : 12/15/2014
Last Update Date : 06/03/2022

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Directions to “TERROS, INC. ” Practice Location

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