| Home Of Grace Counseling Arizona Llc | |
|
4700 S Mill Ave Ste 5 Tempe AZ 85282-6736 | |
| (480) 757-7952 | |
| Not Available |
| Full Name | Home Of Grace Counseling Arizona Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 4700 S Mill Ave Ste 5, Tempe, Arizona |
| Authorized Official Name and Position | Teodosio Gutierrez (DIRECTOR OF OUTPATIENT SERVICES) |
| Authorized Official Contact | 4807577952 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Home Of Grace Counseling Arizona Llc 4700 S Mill Ave Ste 5 Tempe AZ 85282-6736 Ph: (480) 757-7952 | Home Of Grace Counseling Arizona Llc 4700 S Mill Ave Ste 5 Tempe AZ 85282-6736 Ph: (480) 757-7952 |
| NPI Number | 1356119101 |
|---|---|
| Provider Enumeration Date | 12/12/2023 |
| Last Update Date | 08/16/2024 |
| Certification Date | 08/16/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356119101 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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