| Healing Angel Wellness Center, Llc | |
|
4150 W Peoria Ave Ste 211-212 Phoenix AZ 85029-3900 | |
| (602) 281-5504 | |
| Not Available |
| Full Name | Healing Angel Wellness Center, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4150 W Peoria Ave Ste 211-212, Phoenix, Arizona |
| Authorized Official Name and Position | Abdihakin Aden (OWNER) |
| Authorized Official Contact | 6022815504 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healing Angel Wellness Center, Llc 4040 E Mcdowell Rd Ste 320 Phoenix AZ 85008-4447 Ph: (602) 281-5504 | Healing Angel Wellness Center, Llc 4150 W Peoria Ave Ste 211-212 Phoenix AZ 85029-3900 Ph: (602) 281-5504 |
| NPI Number | 1811602857 |
|---|---|
| Provider Enumeration Date | 01/13/2023 |
| Last Update Date | 06/24/2024 |
| Certification Date | 06/24/2024 |
| Medicare PECOS PAC ID | 7517320120 |
|---|---|
| Medicare Enrollment ID | O20230830001903 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811602857 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Latriece Session |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326773342 PECOS PAC ID: 2365812682 Enrollment ID: I20230821003810 |
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