Provider Demographics
NPI:1255592853
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:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANCOIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-503-2010
Mailing Address - Street 1:3230 S GILBERT RD
Mailing Address - Street 2:1
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-5110
Mailing Address - Country:US
Mailing Address - Phone:480-629-5095
Mailing Address - Fax:480-629-5895
Practice Address - Street 1:3230 S GILBERT RD
Practice Address - Street 2:1
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-5110
Practice Address - Country:US
Practice Address - Phone:480-629-5095
Practice Address - Fax:480-629-5895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
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