| Philautia Wellness Centers, Llc | |
|
1002 E Indian School Road Phoenix AZ 85014 | |
| (800) 309-0366 | |
| (800) 309-0366 |
| Full Name | Philautia Wellness Centers, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1002 E Indian School Road, Phoenix, Arizona |
| Authorized Official Name and Position | Sandra Patricia Balinda-kamanyire (MEMBER) |
| Authorized Official Contact | 8003090366 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Philautia Wellness Centers, Llc 1002 E Indian School Road Phoenix AZ 85014 Ph: (800) 309-0366 | Philautia Wellness Centers, Llc 1002 E Indian School Road Phoenix AZ 85014 Ph: (800) 309-0366 |
| NPI Number | 1235907478 |
|---|---|
| Provider Enumeration Date | 12/18/2023 |
| Last Update Date | 02/12/2025 |
| Certification Date | 02/06/2025 |
| Medicare PECOS PAC ID | 7911348511 |
|---|---|
| Medicare Enrollment ID | O20240514002500 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235907478 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Latriece Session |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326773342 PECOS PAC ID: 2365812682 Enrollment ID: I20230821003810 |
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