| Next Level Vitality Llc | |
|
26 W Brahman Blvd San Tan Valley AZ 85143-4852 | |
| (619) 366-1546 | |
| Not Available |
| Full Name | Next Level Vitality Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 26 W Brahman Blvd, San Tan Valley, Arizona |
| Authorized Official Name and Position | Tia Ross (OWNER) |
| Authorized Official Contact | 6193661546 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Next Level Vitality Llc 26 W Brahman Blvd San Tan Valley AZ 85143-4852 Ph: (619) 366-1546 | Next Level Vitality Llc 26 W Brahman Blvd San Tan Valley AZ 85143-4852 Ph: (619) 366-1546 |
| NPI Number | 1407402316 |
|---|---|
| Provider Enumeration Date | 08/15/2019 |
| Last Update Date | 09/22/2022 |
| Certification Date | 09/22/2022 |
| Medicare PECOS PAC ID | 9739573494 |
|---|---|
| Medicare Enrollment ID | O20220223002840 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407402316 | NPI | - | NPPES |
| Provider Name | Lillian L Espinoza |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841643277 PECOS PAC ID: 2567856156 Enrollment ID: I20220422000540 |
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