| Light Center Behavioral Health Llc | |
|
6619 N 19th Ave # C1 Phoenix AZ 85015-1631 | |
| (520) 445-5832 | |
| Not Available |
| Full Name | Light Center Behavioral Health Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 6619 N 19th Ave # C1, Phoenix, Arizona |
| Authorized Official Name and Position | Anne Marie Ntiranyibagira (PARTNER) |
| Authorized Official Contact | 5204455832 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Light Center Behavioral Health Llc 6619 N 19th Ave # C1 Phoenix AZ 85015-1631 Ph: (520) 445-5832 | Light Center Behavioral Health Llc 6619 N 19th Ave # C1 Phoenix AZ 85015-1631 Ph: (520) 445-5832 |
| NPI Number | 1700598489 |
|---|---|
| Provider Enumeration Date | 12/14/2022 |
| Last Update Date | 12/14/2022 |
| Certification Date | 12/14/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700598489 | NPI | - | NPPES |
| BH8241 | Medicaid | AZ |
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