Organization · Type 2 NPI

Blooming Agave Wellness LLC

Adult Mental Health Clinic/Center · Phoenix, AZ

NPI number 1053144154 Active

Practice location

4117 N 17th St
Phoenix, AZ 85016-5921

Call (623) 239-2312 Map

Mailing address

16609 N 34th Pl
Phoenix, AZ 85032-2776

Specialties and licenses

TaxonomyCodeLicense
Adult Mental Health Clinic/Center Primary 261QM0850XNone listed

Adult Mental Health Clinic/Center: An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.

5 other providers at this address

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About NPI 1053144154

Blooming Agave Wellness LLC's National Provider Identifier is 1053144154, issued on Aug 23, 2024. The primary taxonomy on file is Adult Mental Health Clinic/Center (261QM0850X), and the practice location is in Phoenix, AZ. The record was last updated on Aug 23, 2024.