Wellharbor Az LLC
Behavior Analyst in Phoenix, AZ. Organization (NPI-2).
NPI number1104724905
StatusActive
Last updated in NPPESNov 10, 2026
Details
- NPI
- 1104724905
- Entity type
- Organization (NPI-2)
- Legal business name
- Wellharbor Az LLC
- Organization subpart
- No
- Enumeration date
- Oct 30, 2026
- Certification date
- Nov 10, 2026
- Last updated
- Nov 10, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103K00000X | Behavior Analyst | – | – | Yes |
Practice location
10171 N 19th Ave Ste 10Phoenix, AZ 85021-1940
Phone 732-860-8460
Mailing address
10171 N 19th Ave Ste 10Phoenix, AZ 85021-1940
Phone 732-860-8460
Authorized official
Abraham C Samuel
Director
7328608460
Is something wrong?
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