Cactus Wellness Center LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

CACTUS WELLNESS CENTER LLC

Practice address

6037 S 30TH Dr
Phoenix, AZ 85041-6208

Phone

(224) 595-0112

NPI assigned

Mar 26, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Grace Umoren

Title

Manager

Phone

(224) 595-0112

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1648252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648252800000",
    "number": "1154071710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6037 S 30TH DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850416208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6037 S 30TH DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850416208",
            "telephone_number": "224-595-0112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CACTUS WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-26",
        "last_updated": "2022-03-26",
        "certification_date": "2022-03-26",
        "status": "A",
        "authorized_official_last_name": "UMOREN",
        "authorized_official_first_name": "GRACE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "224-595-0112"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Illness Community Based Residential Treatment Facility in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Mental Illness Community Based Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.