| Cornerstone Healing Center, Llc | |
|
16444 N 91st St Scottsdale AZ 85260-1567 | |
| (800) 480-1781 | |
| (480) 590-7303 |
| Full Name | Cornerstone Healing Center, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 16444 N 91st St, Scottsdale, Arizona |
| Authorized Official Name and Position | Estil Wallace (CEO) |
| Authorized Official Contact | 8004801781 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cornerstone Healing Center, Llc 16444 N 91st St Scottsdale AZ 85260-1567 Ph: (800) 480-1781 | Cornerstone Healing Center, Llc 16444 N 91st St Scottsdale AZ 85260-1567 Ph: (800) 480-1781 |
| NPI Number | 1154823680 |
|---|---|
| Provider Enumeration Date | 02/28/2018 |
| Last Update Date | 09/20/2021 |
| Certification Date | 09/20/2021 |
| Medicare PECOS PAC ID | 4385179902 |
|---|---|
| Medicare Enrollment ID | O20250109004097 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154823680 | NPI | - | NPPES |
| Provider Name | Fayz Yar Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043476096 PECOS PAC ID: 1456405810 Enrollment ID: I20090917000346 |
| Provider Name | Craig W Heise |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629398912 PECOS PAC ID: 9234364050 Enrollment ID: I20131104000990 |
| Provider Name | Jillian Eve Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134614324 PECOS PAC ID: 8820347685 Enrollment ID: I20180828001372 |
| Provider Name | Nilah Bryant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518539550 PECOS PAC ID: 6103223516 Enrollment ID: I20210928003021 |
| Provider Name | Kaitlin Spivey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003530635 PECOS PAC ID: 6204204357 Enrollment ID: I20221121001194 |
| Provider Name | Eboni Fields |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043853807 PECOS PAC ID: 7012431331 Enrollment ID: I20250408003119 |
| Provider Name | Nathaniel Bush |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689453326 PECOS PAC ID: 8628592631 Enrollment ID: I20250411001912 |
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