Provider Demographics
NPI:1831346840
Name:THE CENTER FOR PAIN RELIEF, LLC
Entity type:Organization
Organization Name:THE CENTER FOR PAIN RELIEF, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:
Authorized Official - First Name:VENUS
Authorized Official - Middle Name:
Authorized Official - Last Name:GAINES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-535-8984
Mailing Address - Street 1:515 E CAREFREE HWY # 1023
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-8839
Mailing Address - Country:US
Mailing Address - Phone:623-486-1510
Mailing Address - Fax:623-486-1529
Practice Address - Street 1:515 E CAREFREE HWY # 1023
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85085-8839
Practice Address - Country:US
Practice Address - Phone:623-486-1510
Practice Address - Fax:623-486-1529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-20
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTC4422261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical