Alliance With The Covenant Of The Trinity Arizona INC
Nurse Practitioner, Gerontology in Phoenix, AZ. Organization (NPI-2).
NPI number1013552124
StatusActive
Last updated in NPPESNov 12, 2019
Details
- NPI
- 1013552124
- Entity type
- Organization (NPI-2)
- Legal business name
- Alliance With The Covenant Of The Trinity Arizona INC
- Organization subpart
- No
- Enumeration date
- Nov 12, 2019
- Last updated
- Nov 12, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LG0600X | Nurse Practitioner, Gerontology | – | – | Yes |
Other names
- Act Medical Group Arizona (Doing Business As)
Practice location
2 N Central Ave Fl 18Phoenix, AZ 85004-2322
Phone 213-709-0777
Mailing address
11245 Delano StNorth Hollywood, CA 91606-4219
Phone 213-709-0777
Authorized official
Zandra Gonzales
Cfo/Coo
2137090777
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