Provider Demographics
NPI:1770272361
Name:HELLO FAZIE LLC
Entity type:Organization
Organization Name:HELLO FAZIE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:FAZIRAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MUTONI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-266-4198
Mailing Address - Street 1:3877 N 7TH ST STE 230
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-5075
Mailing Address - Country:US
Mailing Address - Phone:747-266-4198
Mailing Address - Fax:
Practice Address - Street 1:3877 N 7TH ST STE 230
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-5075
Practice Address - Country:US
Practice Address - Phone:747-266-4198
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health