| Coll Community Services Llc | |
|
4545 N 67th Ave Unit 1109 Phoenix AZ 85033-1670 | |
| (954) 544-9065 | |
| Not Available |
| Full Name | Coll Community Services Llc |
|---|---|
| Speciality | Psychiatric Residential Treatment Facility |
| Location | 4545 N 67th Ave Unit 1109, Phoenix, Arizona |
| Authorized Official Name and Position | Collins Kukwa Ayeah (ADMINISTRATOR) |
| Authorized Official Contact | 9545449065 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coll Community Services Llc 4545 N 67th Ave Unit 1109 Phoenix AZ 85033-1670 Ph: (954) 544-9065 | Coll Community Services Llc 4545 N 67th Ave Unit 1109 Phoenix AZ 85033-1670 Ph: (954) 544-9065 |
| NPI Number | 1700472180 |
|---|---|
| Provider Enumeration Date | 12/18/2020 |
| Last Update Date | 10/02/2024 |
| Certification Date | 10/02/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700472180 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 323P00000X | Psychiatric Residential Treatment Facility | (* (Not Available)) | Primary |
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