Organization · NPI-2

Advanced Wellness Homes

Clinic/Center, Mental Health (Including Community Mental Health Center) · Tempe, AZ

NPI number1992695316
StatusActive
Last updated in NPPESJul 7, 2025

Details

NPI
1992695316
Entity type
Organization (NPI-2)
Legal business name
Advanced Wellness Homes
Organization subpart
No
Enumeration date
Jul 7, 2025
Certification date
Jul 7, 2025
Last updated
Jul 7, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)––Yes
261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder––

Practice location

2520 S Plaza Dr Apt 3070
Tempe, AZ 85282-1058

Phone 507-884-3032

Mailing address

2520 S Plaza Dr Apt 3070
Tempe, AZ 85282-1058

Phone 507-884-3032

Authorized official

Omar Idiris
Owner
5078843032

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