| Dutiful Angels Behavioral Clinic | |
|
908 W Chandler Blvd Suite B3 Chandler AZ 85225-8522 | |
| (602) 880-1851 | |
| (702) 608-7752 |
| Full Name | Dutiful Angels Behavioral Clinic |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 908 W Chandler Blvd, Chandler, Arizona |
| Authorized Official Name and Position | Craig Duerson (ADMINISTRATOR) |
| Authorized Official Contact | 6028801851 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dutiful Angels Behavioral Clinic 43713 W Cowpath Rd Maricopa AZ 85138-5662 Ph: (702) 820-6186 | Dutiful Angels Behavioral Clinic 908 W Chandler Blvd Suite B3 Chandler AZ 85225-8522 Ph: (602) 880-1851 |
| NPI Number | 1821765207 |
|---|---|
| Provider Enumeration Date | 08/24/2021 |
| Last Update Date | 06/10/2022 |
| Certification Date | 06/10/2022 |
| Medicare PECOS PAC ID | 1557715430 |
|---|---|
| Medicare Enrollment ID | O20230926002860 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821765207 | NPI | - | NPPES |
| Provider Name | Tyrone Antonio Simon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619212792 PECOS PAC ID: 1254714280 Enrollment ID: I20220823004098 |
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