Agricola Wellness Center Llc

LBN: Agricola Wellness Center Llc
Agricola Wellness Center Llc is an health care organization with primary practice located at 2150 S Country Club Dr Ste 29 , Mesa AZ 85210-6860. The organization recently has only one registered license in Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), which is considered as the primary health care specialty. Agricola Wellness Center Llc can be contacted via phone (404) 697-7506, or through Barrow, Dwayne via phone (404) 697-7506.

Contact Information

Primary practice address
2150 S Country Club Dr Ste 29 Mesa AZ 85210-6860
Phone: (404) 697-7506
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Barrow, Dwayne
Phone: (404) 697-7506

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X

Profile Details

NPI number 1447970066
LBN Legal business name Agricola Wellness Center Llc
DBA Doing business as
Authorized official Barrow, Dwayne
Entity Organization
Organization subpart 1 No
Enumeration date Sep 1st, 2022
Last updated Sep 1st, 2022 - about 3 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 1447970066 NPPES
Arizona Other OTC11904 ADHS

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