| The Ignite Care Group, Pllc | |
|
12175 W Mcdowell Rd Apt 1218 Avondale AZ 85392-5303 | |
| (832) 866-5726 | |
| Not Available |
| Full Name | The Ignite Care Group, Pllc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 12175 W Mcdowell Rd Apt 1218, Avondale, Arizona |
| Authorized Official Name and Position | Ketura C James (PMHNP) |
| Authorized Official Contact | 8328665726 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Ignite Care Group, Pllc 875 S Estrella Pkwy Unit 7823 Goodyear AZ 85338-8614 Ph: (832) 866-5726 | The Ignite Care Group, Pllc 12175 W Mcdowell Rd Apt 1218 Avondale AZ 85392-5303 Ph: (832) 866-5726 |
| NPI Number | 1275208746 |
|---|---|
| Provider Enumeration Date | 08/16/2021 |
| Last Update Date | 08/16/2021 |
| Certification Date | 08/16/2021 |
| Medicare PECOS PAC ID | 1153797279 |
|---|---|
| Medicare Enrollment ID | O20221014001107 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275208746 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Ketura C James |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548508237 PECOS PAC ID: 4284860529 Enrollment ID: I20200706000167 |
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