Provider Demographics
NPI:1730891375
Name:FARD HEALTH SERVICES LLC
Entity type:Organization
Organization Name:FARD HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS (DOP)
Authorized Official - Prefix:
Authorized Official - First Name:FAITH
Authorized Official - Middle Name:JENNIFER
Authorized Official - Last Name:OGUDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-425-6829
Mailing Address - Street 1:1990 W CAMELBACK RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-3462
Mailing Address - Country:US
Mailing Address - Phone:623-295-6057
Mailing Address - Fax:
Practice Address - Street 1:1990 W CAMELBACK RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-3462
Practice Address - Country:US
Practice Address - Phone:623-295-6057
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-14
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)