Provider Demographics
NPI:1538670880
Name:NOBILIS ARIZONA HOLDING COMPANY LLC
Entity Type:Organization
Organization Name:NOBILIS ARIZONA HOLDING COMPANY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CSO
Authorized Official - Prefix:
Authorized Official - First Name:MARISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARREOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-256-9455
Mailing Address - Street 1:11700 KATY FWY STE 300
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-1218
Mailing Address - Country:US
Mailing Address - Phone:713-355-8614
Mailing Address - Fax:
Practice Address - Street 1:9377 E BELL RD STE 143
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260
Practice Address - Country:US
Practice Address - Phone:480-619-4097
Practice Address - Fax:480-619-4098
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHSTAR HEALTHCARE ACQUISITIONS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-10-13
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty