| Center Street | |
|
5949 W Northern Ave Ste 201 Glendale AZ 85301-7829 | |
| (323) 233-1675 | |
| Not Available |
| Full Name | Center Street |
|---|---|
| Speciality | Clinic/center - Rehabilitation |
| Location | 5949 W Northern Ave Ste 201, Glendale, Arizona |
| Authorized Official Name and Position | Nilah Emage Asy Jamie Quinones (OWNER) |
| Authorized Official Contact | 3233167585 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Center Street 2739 W Rancho Dr Phoenix AZ 85017-2645 Ph: () - | Center Street 5949 W Northern Ave Ste 201 Glendale AZ 85301-7829 Ph: (323) 233-1675 |
| NPI Number | 1790401388 |
|---|---|
| Provider Enumeration Date | 10/14/2022 |
| Last Update Date | 10/18/2022 |
| Certification Date | 10/18/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790401388 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 261QR0400X | Clinic/center - Rehabilitation | (* (Not Available)) | Primary |
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