Provider Demographics
NPI:1811567886
Name:NAZCARE - SERENITY CIRCLE WELLNESS CENTER
Entity Type:Organization
Organization Name:NAZCARE - SERENITY CIRCLE WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:BILLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-442-9205
Mailing Address - Street 1:8128 E STATE ROUTE 69 STE 201
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86314-9459
Mailing Address - Country:US
Mailing Address - Phone:928-442-9205
Mailing Address - Fax:
Practice Address - Street 1:1229 E CHERRY ST
Practice Address - Street 2:
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-3458
Practice Address - Country:US
Practice Address - Phone:928-634-1168
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NAZCARE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-30
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Multi-Specialty