Wallace'S Place

LBN: Wallace'S Place
Wallace'S Place is an health care organization with primary practice located at 9636 W Oberlin Way , Peoria AZ 85383-8750. The organization recently has only one registered license in Agencies / Community/Behavioral Health, which is considered as the primary health care specialty. Wallace'S Place can be contacted via phone (623) 203-1148, or through Clark, Cynthia Lynn via phone (623) 203-1148.

Contact Information

Primary practice address
9636 W Oberlin Way Peoria AZ 85383-8750
Phone: (623) 203-1148
Fax: (623) 825-4639
Website:
Map and Directions
Authorized official contact:
Name: Clark, Cynthia Lynn BSN RNC
Phone: (623) 203-1148

Health care specialties

SpecialtyCodeLicense #State
Agencies / Community/Behavioral Health 251S00000X

Profile Details

NPI number 1649441866
LBN Legal business name Wallace'S Place
DBA Doing business as
Authorized official Clark, Cynthia Lynn BSN RNC
Entity Organization
Organization subpart 1 No
Enumeration date Mar 15th, 2008
Last updated Mar 15th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649441866 NPPES
Arizona Other 304367 AHCCCS

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