| Open Hearts | |
|
4414 N 19th Ave Phoenix AZ 85015 | |
| (602) 285-5550 | |
| (602) 285-5551 |
| Full Name | Open Hearts |
|---|---|
| Speciality | Counselor |
| Location | 4414 N 19th Ave, Phoenix, Arizona |
| Authorized Official Name and Position | Arjelia Gomez (PRESIDENT & CEO) |
| Authorized Official Contact | 6022855550 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Open Hearts 4414 N 19th Ave Phoenix AZ 85015 Ph: (602) 285-5550 | Open Hearts 4414 N 19th Ave Phoenix AZ 85015 Ph: (602) 285-5550 |
| NPI Number | 1265544324 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 05/29/2020 |
| Certification Date | 05/29/2020 |
| Medicare PECOS PAC ID | 4587003777 |
|---|---|
| Medicare Enrollment ID | O20240422000184 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265544324 | NPI | - | NPPES |
| 349127 | Medicaid | AZ |
| Provider Name | Cinthya Gimena Knapper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235754771 PECOS PAC ID: 7113331786 Enrollment ID: I20210122002317 |
| Provider Name | James Daniel Mccreary |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528691128 PECOS PAC ID: 5092122259 Enrollment ID: I20240423000932 |
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