Provider Demographics
NPI:1881410504
Name:ROOTED ALMA, LLC
Entity type:Organization
Organization Name:ROOTED ALMA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHEREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BREUER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:602-345-0730
Mailing Address - Street 1:3241 E SHEA BLVD # 135
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-3335
Mailing Address - Country:US
Mailing Address - Phone:602-345-0730
Mailing Address - Fax:
Practice Address - Street 1:333 W ROOSEVELT ST # 200
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85003-1324
Practice Address - Country:US
Practice Address - Phone:602-345-0730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-26
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty