Individual provider · Type 1 NPI
Johnwick Nathan
Substance Abuse Rehabilitation Facility · Laveen, AZ
NPI number
1306327770
Active
Practice location
6736 W Carson Rd
Laveen, AZ 85339-7024
Mailing address
3950 W Chandler Blvd Apt 3049
Chandler, AZ 85226-2662
Other practice locations
- 7015 N 23rd Ln, Phoenix, AZ 85021-7605 · (860) 938-6845
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor | 101YM0800X | None listed |
| Community/Behavioral Health Agency | 251S00000X | None listed |
| Substance Abuse Rehabilitation Facility Primary | 324500000X | None listed |
Substance Abuse Rehabilitation Facility: A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
3 other providers at this address
About NPI 1306327770
Johnwick Nathan's National Provider Identifier is 1306327770, issued on Aug 23, 2018. The primary taxonomy on file is Substance Abuse Rehabilitation Facility (324500000X), and the practice location is in Laveen, AZ. The record was last updated on Aug 23, 2018.