# DIVINE WELLNESS PSYCHIATRIC SERVICES PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245007210
- **Authorized official:** IHEANYI AMANWANNE (OWNER)
- **Authorized official phone:** (602) 465-6011

## Contact information

- **Practice address:** 3101 N CENTRAL AVE STE 183, PHOENIX, AZ 85012-3616
- **Practice address phone:** (602) 465-6011
- **Mailing address:** 3880 W RANIER CT STE 183, ANTHEM, AZ 85086-8018
- **Mailing address phone:** (602) 465-6011

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 12/08/2023
- **Last updated:** 12/08/2023