Provider Demographics
NPI:1699578252
Name:WILDFLOWER URGENT PSYCHIATRIC SERVICES
Entity type:Organization
Organization Name:WILDFLOWER URGENT PSYCHIATRIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-505-1621
Mailing Address - Street 1:2375 E CAMELBACK RD STE 600
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-3493
Mailing Address - Country:US
Mailing Address - Phone:623-227-9564
Mailing Address - Fax:623-321-6563
Practice Address - Street 1:9002 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-2405
Practice Address - Country:US
Practice Address - Phone:623-227-9564
Practice Address - Fax:623-321-6563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-29
Last Update Date:2025-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health