DENOVA COLLABORATIVE HEALTH LLC NPI 1871915827

NPI Information

NPI: 1871915827
Provider Name: DENOVA COLLABORATIVE HEALTH, LLC

Doing Business As: BAYLESS HEALTHCARE GROUP

Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
3033 N CENTRAL AVE
700
PHOENIX, AZ
ZIP 85012
Phone: (602) 230-7373
Get Directions

DENOVA COLLABORATIVE HEALTH, LLC is a multi-specialty clinic center in Phoenix, AZ. DENOVA COLLABORATIVE HEALTH, LLC NPI is 1871915827. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Bayless Healthcare Group.

The provider's business location address is:

3033 N CENTRAL AVE
700
PHOENIX, AZ
ZIP 85012-809
Phone: (602) 230-7373
Fax: (602) 682-7455

The provider's authorized official is Graham Johnson .
The authorized official title is Ceo and has the following contact phone number (602) 230-7373.

The CLIA number assigned to this NPI record is 03D2293223 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/10/2014 and was last updated on 10/24/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional	OTC8131	ARIZONA	No
2	208000000X	Pediatrics		OTC8131	ARIZONA	No
3	2084P0800X	Psychiatry & Neurology	Psychiatry	OTC8131	ARIZONA	No
4	208D00000X	General Practice		OTC8131	ARIZONA	No
5	261QM1300X	Clinic/Center	Multi-Specialty	OTC5758	ARIZONA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	170664	MEDICAID	ARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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