| NPI | 1801421656 |
|---|---|
| Doing Business As | CLEANSLATE CENTERS- NORTH 40TH PHOENIX, AZ. |
| Entity Type | Organization |
| Authorized Contact | MATTHEW PHILIP SMOLAREK CFO 412-999-5188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 261QM0850X Clinic/Center Adult Mental Health | |
| Enumeration Date | 2020-03-11 |
| Last Update Date | 2024-07-03 |