Provider Demographics
NPI:1659533966
Name:CONTINUUM WELLNESS CLINIC
Entity Type:Organization
Organization Name:CONTINUUM WELLNESS CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEB
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANCOIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-503-2010
Mailing Address - Street 1:1075 E IDAHO ROAD
Mailing Address - Street 2:#210
Mailing Address - City:APACHE JUNCTION
Mailing Address - State:AZ
Mailing Address - Zip Code:85219
Mailing Address - Country:US
Mailing Address - Phone:480-983-0877
Mailing Address - Fax:
Practice Address - Street 1:1075 E IDAHO ROAD
Practice Address - Street 2:#210
Practice Address - City:APACHE JUNCTION
Practice Address - State:AZ
Practice Address - Zip Code:85219
Practice Address - Country:US
Practice Address - Phone:480-983-0877
Practice Address - Fax:480-983-3172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-27
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1727261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ296349Medicaid
AZ296349Medicaid