| Copperstatebh Llc | |
|
17336 W Cheryl Dr Waddell AZ 85355-9716 | |
| (623) 536-5212 | |
| Not Available |
| Full Name | Copperstatebh Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 17336 W Cheryl Dr, Waddell, Arizona |
| Authorized Official Name and Position | John Williams (PRESIDENT) |
| Authorized Official Contact | 6235365212 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Copperstatebh Llc 17336 W Cheryl Dr Waddell AZ 85355-9716 Ph: (623) 536-5212 | Copperstatebh Llc 17336 W Cheryl Dr Waddell AZ 85355-9716 Ph: (623) 536-5212 |
| NPI Number | 1659267276 |
|---|---|
| Provider Enumeration Date | 06/18/2025 |
| Last Update Date | 06/18/2025 |
| Certification Date | 06/18/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659267276 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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