| Destiny Outpatient Services | |
|
5308 N 17th Ave Phoenix AZ 85015-3035 | |
| (602) 249-6674 | |
| (602) 926-0590 |
| Full Name | Destiny Outpatient Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5308 N 17th Ave, Phoenix, Arizona |
| Authorized Official Name and Position | Kathleen Geor-zell Bynum (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6023278375 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Destiny Outpatient Services 5306 N 17th Ave Phoenix AZ 85015-3035 Ph: (602) 249-6674 | Destiny Outpatient Services 5308 N 17th Ave Phoenix AZ 85015-3035 Ph: (602) 249-6674 |
| NPI Number | 1336593045 |
|---|---|
| Provider Enumeration Date | 04/19/2016 |
| Last Update Date | 04/19/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336593045 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | OTC7551 (Arizona) | Primary |
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