| Denova Collaborative Health, Llc | |
|
506 E Western Ave Ste 104 Avondale AZ 85323-2422 | |
| (602) 230-7373 | |
| (602) 230-3086 |
| Full Name | Denova Collaborative Health, Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 506 E Western Ave Ste 104, Avondale, Arizona |
| Authorized Official Name and Position | Laura Ratto (DIRECTOR QUALITY & CREDENTIALING) |
| Authorized Official Contact | 6022307373 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Denova Collaborative Health, Llc 3101 N Central Ave Ste 550 Phoenix AZ 85012-2635 Ph: (602) 230-7373 | Denova Collaborative Health, Llc 506 E Western Ave Ste 104 Avondale AZ 85323-2422 Ph: (602) 230-7373 |
| NPI Number | 1689153769 |
|---|---|
| Provider Enumeration Date | 08/09/2018 |
| Last Update Date | 06/26/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689153769 | NPI | - | NPPES |
| 494475 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | OTC9070 (Arizona) | Primary |
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