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Organization
ANGEL HEART BEHAVIORAL HEALTH II LLC
Active
Organization
ANGEL HEART BEHAVIORAL HEALTH II LLC
Active
Other names
ANGEL HEART BEHAVIORAL HEALTH II LLC
Organization subpart
No
Provider details
NPI number
Authorized official
AIMEE NYIRAKANYANA (CEO)
(207) 409-6515
Entity
Organization
Contact information
Practice address
7432 W GLENROSA AVE, PHOENIX, AZ 85033-2518
(207) 409-6515
Mailing address
7432 W GLENROSA AVE, PHOENIX, AZ 85033-2518
(207) 409-6515
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
BH5941
—
AZ
Enumeration date
12/09/2019
Last updated
12/09/2019
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