| Obsidian Health And Wellness Llc | |
|
13321 W Indian School Rd Ste A107 Litchfield Park AZ 85340-4339 | |
| (623) 293-2232 | |
| (623) 321-9524 |
| Full Name | Obsidian Health And Wellness Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 13321 W Indian School Rd Ste A107, Litchfield Park, Arizona |
| Authorized Official Name and Position | Deborah Grace (CONSULTANT) |
| Authorized Official Contact | 6026963556 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Obsidian Health And Wellness Llc 13321 W Indian School Rd Ste A107 Litchfield Park AZ 85340-4339 Ph: (623) 293-2232 | Obsidian Health And Wellness Llc 13321 W Indian School Rd Ste A107 Litchfield Park AZ 85340-4339 Ph: (623) 293-2232 |
| NPI Number | 1417593575 |
|---|---|
| Provider Enumeration Date | 11/25/2019 |
| Last Update Date | 11/25/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417593575 | NPI | - | NPPES |
| 435346 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
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