Provider Demographics
NPI:1689414153
Name:GENEVA MIND & WELLNESS PSYCHIATRIC SERVICES LLC
Entity type:Organization
Organization Name:GENEVA MIND & WELLNESS PSYCHIATRIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:
Authorized Official - First Name:GENEVIEVE
Authorized Official - Middle Name:IJEOMA
Authorized Official - Last Name:ONYIRIMBA
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:623-760-6381
Mailing Address - Street 1:4579 N VILLAGE PKWY
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD PARK
Mailing Address - State:AZ
Mailing Address - Zip Code:85340-2761
Mailing Address - Country:US
Mailing Address - Phone:623-760-6381
Mailing Address - Fax:623-322-3268
Practice Address - Street 1:4579 N VILLAGE PKWY
Practice Address - Street 2:
Practice Address - City:LITCHFIELD PARK
Practice Address - State:AZ
Practice Address - Zip Code:85340-2761
Practice Address - Country:US
Practice Address - Phone:623-760-6381
Practice Address - Fax:623-322-3268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-30
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty