| Angel Heart Behavioral Health | |
|
11114 W College Dr Phoenix AZ 85037-1269 | |
| (207) 409-6515 | |
| (623) 777-0427 |
| Full Name | Angel Heart Behavioral Health |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 11114 W College Dr, Phoenix, Arizona |
| Authorized Official Name and Position | Aimee N Nyirakanyana (ADMINISTRATOR) |
| Authorized Official Contact | 2074096515 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Angel Heart Behavioral Health 11114 W College Dr Phoenix AZ 85037-1269 Ph: (207) 409-6515 | Angel Heart Behavioral Health 11114 W College Dr Phoenix AZ 85037-1269 Ph: (207) 409-6515 |
| NPI Number | 1255820098 |
|---|---|
| Provider Enumeration Date | 05/08/2018 |
| Last Update Date | 05/08/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255820098 | NPI | - | NPPES |
| 00000 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Arizona) | Primary |
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