Provider Demographics
NPI:1689705154
Name:THE MEADOWS OF WICKENBURG, INC.
Entity Type:Organization
Organization Name:THE MEADOWS OF WICKENBURG, INC.
Other - Org Name:THE MEADOWS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF REVENUE CYCLE
Authorized Official - Prefix:MS
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:LIVINGSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-256-3020
Mailing Address - Street 1:19820 N 7TH ST STE 205
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85024-1694
Mailing Address - Country:US
Mailing Address - Phone:602-256-3020
Mailing Address - Fax:
Practice Address - Street 1:1655 N TEGNER ST
Practice Address - Street 2:
Practice Address - City:WICKENBURG
Practice Address - State:AZ
Practice Address - Zip Code:85390-1461
Practice Address - Country:US
Practice Address - Phone:928-684-3926
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH4159283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital