Innercore Transformation

NPI #1982454377 in Snowflake, Arizona

Provider Information

NPI Number: 1982454377
Entity Type: Organization
Organization Name: Innercore Transformation
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Mar 26, 2024
Last Updated: Mar 26, 2024

Practice Location

Address: 1403 LOBO TRL
City: Snowflake
State: Arizona
ZIP Code: 85937-5465
Phone: (190) 777-5874

Authorized Official

Name: LINDA A RASMUSSEN, LCSW
Title: PRESIDENT
Phone: (907) 775-8742

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Adult Mental Health — Adult Mental Health	261QM0850X
Clinic/Center - Adolescent and Children Mental Health — Adolescent and Children Mental Health	261QM0855X
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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