| Faith Group Angels, Llc | |
|
5308 W Novak Way Laveen AZ 85339 | |
| (623) 218-8074 | |
| Not Available |
| Full Name | Faith Group Angels, Llc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 5308 W Novak Way, Laveen, Arizona |
| Authorized Official Name and Position | Urejo Hassan Haji Bare (OWNER) |
| Authorized Official Contact | 6232188074 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Faith Group Angels, Llc 5308 W Novak Way Laveen AZ 85339 Ph: (623) 218-8074 | Faith Group Angels, Llc 5308 W Novak Way Laveen AZ 85339 Ph: (623) 218-8074 |
| NPI Number | 1750014726 |
|---|---|
| Provider Enumeration Date | 07/06/2022 |
| Last Update Date | 07/06/2022 |
| Certification Date | 07/06/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750014726 | NPI | - | NPPES |
| 1922739663 | Other | AZ | BEHAVIORAL HEALTH RESIDENTIAL FACILITY OPERATOR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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