| Blackhorse Therapy And Wellness Llc | |
|
2425 S 121st Dr Avondale AZ 85323-7667 | |
| (602) 350-1648 | |
| Not Available |
| Full Name | Blackhorse Therapy And Wellness Llc |
|---|---|
| Speciality | Counselor |
| Location | 2425 S 121st Dr, Avondale, Arizona |
| Authorized Official Name and Position | Floriann Blackhorse (OWNER) |
| Authorized Official Contact | 6023501648 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blackhorse Therapy And Wellness Llc Po Box 214 Avondale AZ 85323-0080 Ph: (602) 350-1648 | Blackhorse Therapy And Wellness Llc 2425 S 121st Dr Avondale AZ 85323-7667 Ph: (602) 350-1648 |
| NPI Number | 1306594031 |
|---|---|
| Provider Enumeration Date | 03/11/2022 |
| Last Update Date | 03/11/2022 |
| Certification Date | 03/11/2022 |
| Medicare PECOS PAC ID | 6406237544 |
|---|---|
| Medicare Enrollment ID | O20220720001550 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306594031 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Floriann Blackhorse |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386040608 PECOS PAC ID: 9537491311 Enrollment ID: I20191028002490 |
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