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Organization
DIVINE CHANGING HANDS
Active
Organization
DIVINE CHANGING HANDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIRSANDRA SCOTT (OWNER)
(702) 773-2872
Entity
Organization
Contact information
Practice address
1550 E MCKELLIPS RD STE 101, MESA, AZ 85203-2753
(480) 597-4951
(480) 597-3689
Mailing address
1550 E MCKELLIPS RD STE 101, MESA, AZ 85203-2753
(480) 597-4951
(480) 597-3689
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
080174
—
AZ
Enumeration date
05/05/2020
Last updated
04/08/2022
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