| Immanuel Behavioral Health Counseling Clinic | |
|
11301 N 99th Ave Ste 5120 Peoria AZ 85345-5485 | |
| (623) 876-6379 | |
| (623) 876-6379 |
| Full Name | Immanuel Behavioral Health Counseling Clinic |
|---|---|
| Speciality | Clinic/center |
| Location | 11301 N 99th Ave Ste 5120, Peoria, Arizona |
| Authorized Official Name and Position | Brenda Kay Pierce (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 6237388549 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Immanuel Behavioral Health Counseling Clinic 11301 N 99th Ave Ste 5120 Peoria AZ 85345-5485 Ph: (623) 876-6379 | Immanuel Behavioral Health Counseling Clinic 11301 N 99th Ave Ste 5120 Peoria AZ 85345-5485 Ph: (623) 876-6379 |
| NPI Number | 1104495084 |
|---|---|
| Provider Enumeration Date | 06/23/2021 |
| Last Update Date | 04/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104495084 | NPI | - | NPPES |
| 447591 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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