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Organization
HOME OF GRACE COUNSELING ARIZONA LLC
Active
Organization
HOME OF GRACE COUNSELING ARIZONA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TEODOSIO GUTIERREZ (DIRECTOR OF OUTPATIENT SERVICES)
(480) 757-7952
Entity
Organization
Contact information
Practice address
4700 S MILL AVE STE 5, TEMPE, AZ 85282-6736
(480) 757-7952
Mailing address
4700 S MILL AVE STE 5, TEMPE, AZ 85282-6736
(480) 757-7952
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
NULL
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/12/2023
Last updated
08/16/2024
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