NPI:
1689153769
Provider Name:
DENOVA COLLABORATIVE HEALTH, LLC
Doing Business As: DENOVA COLLABORATIVE HEALTH, LLC
Classification:
Clinic/Center - 261QM1300X
Entity Type:
Organization
Specialization: Multi-Specialty
CLIA Number: 03D2149315
Address:
235 W WESTERN AVE
AVONDALE, AZ
ZIP 85323
Phone:
(602) 230-7373
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DENOVA COLLABORATIVE HEALTH, LLC is a multi-specialty clinic center in Avondale, AZ. DENOVA COLLABORATIVE HEALTH, LLC NPI is 1689153769. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Denova Collaborative Health, Llc.
The provider's business location address is:
235 W WESTERN AVE
AVONDALE, AZ
ZIP 85323-848
Phone: (602) 230-7373
Fax: (623) 230-3086
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 03D2149315 - community clinic with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 8/9/2018 and was last updated on 10/24/2023.