Shalom Integrated Behavioral Clinic Llc | |
540 W Iron Ave Ste 201-204 Mesa AZ 85210-6025 | |
(520) 304-8856 | |
(480) 582-6043 |
Full Name | Shalom Integrated Behavioral Clinic Llc |
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Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 540 W Iron Ave Ste 201-204, Mesa, Arizona |
Authorized Official Name and Position | George Barielup Nyone (ADMINISTRATIVE OFFICER) |
Authorized Official Contact | 5203048856 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Shalom Integrated Behavioral Clinic Llc 540 W Iron Ave Ste 201-204 Mesa AZ 85210-6025 Ph: (520) 304-8856 | Shalom Integrated Behavioral Clinic Llc 540 W Iron Ave Ste 201-204 Mesa AZ 85210-6025 Ph: (520) 304-8856 |
NPI Number | 1922728088 |
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Provider Enumeration Date | 08/30/2022 |
Last Update Date | 08/30/2022 |
Certification Date | 08/30/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1922728088 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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