Provider Demographics
NPI:1518648336
Name:CHEMICHEMI FAMILY LIFE COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:CHEMICHEMI FAMILY LIFE COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KIMANI
Authorized Official - Suffix:
Authorized Official - Credentials:BSN/RN
Authorized Official - Phone:623-866-2451
Mailing Address - Street 1:10240 W BELL RD
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351-1153
Mailing Address - Country:US
Mailing Address - Phone:623-213-8192
Mailing Address - Fax:
Practice Address - Street 1:10240 W BELL RD
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-1153
Practice Address - Country:US
Practice Address - Phone:623-213-8192
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-25
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty