SYCAMORE INTEGRATED HEALTH LLC NPI 1205426053

NPI Information

NPI: 1205426053
Provider Name: SYCAMORE INTEGRATED HEALTH LLC
Classification: Clinic/Center - 261QA0600X
Entity Type: Organization

Specialization: Adult Day Care

CLIA Number: 03D2275766

Address:
1350 E MCKELLIPS RD STE 5
MESA, AZ
ZIP 85203
Phone: (480) 833-1440
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SYCAMORE INTEGRATED HEALTH LLC is an adult day care clinic center in Mesa, AZ. SYCAMORE INTEGRATED HEALTH LLC NPI is 1205426053. The provider is registered as an organization entity type.

The provider's business location address is:

1350 E MCKELLIPS RD STE 5
MESA, AZ
ZIP 85203-739
Phone: (480) 833-1440

The provider's authorized official is Imma Nzomo .
The authorized official title is Administrator and has the following contact phone number (480) 608-4877.

The CLIA number assigned to this NPI record is 03D2275766 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/25/2021 and was last updated on 7/26/2023.

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	Primary
1	261Q00000X	Clinic/Center		No
2	261QM0850X	Clinic/Center	Adult Mental Health	No
3	261QP2300X	Clinic/Center	Primary Care	No
4	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	No
5	363LP2300X	Nurse Practitioner	Primary Care	No
6	261QA0600X	Clinic/Center	Adult Day Care	Yes

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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