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1053144154
BLOOMING AGAVE WELLNESS LLC
PHOENIX, AZ
NPI
1053144154
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Entity Type
Organization
Authorized Contact
JOSHUA PHILLIPS
Therapist/Owner
970-260-8286
Organization Subpart ?
No
Primary Taxonomy
261QM0850X Clinic/Center, Adult Mental Health
Enumeration Date
2024-08-23
Last Update Date
2024-08-23
Business Address
BLOOMING AGAVE WELLNESS LLC
4117 N 17TH ST
PHOENIX, AZ 85016-5921
Phone number: 623-239-2312
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Mailing Address
BLOOMING AGAVE WELLNESS LLC
16609 N 34TH PL
PHOENIX, AZ 85032-2776
Phone number: 970-260-8286
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