Empire Wellness and Treatment Center LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

EMPIRE WELLNESS AND TREATMENT CENTER LLC

Doing business as

Empire wellness and Treatment center llc

Practice address

1830 W Colter St Ste 206
Phoenix, AZ 85015-9001

Phone

(502) 218-9762

NPI assigned

Jul 29, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Daniel Fallah

Title

Ceo

Phone

(502) 218-9762

Specialties & licenses 1

Addresses

Other names 1

• Empire wellness and Treatment center llc Doing business as

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

{
    "created_epoch": "1659052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659052800000",
    "number": "1992431027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 W COLTER ST STE 206",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850159001",
            "telephone_number": "502-218-9762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 W COLTER ST STE 206",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850159001",
            "telephone_number": "502-218-9762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMPIRE WELLNESS AND TREATMENT CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-29",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A",
        "authorized_official_last_name": "FALLAH",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "502-218-9762",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Empire wellness and Treatment center llc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Behavioral Health Agency in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Community/Behavioral Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.