# MANA PSYCHIATRY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mana Psychiatry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558196824
- **Authorized official:** DR. REY JERICOH MANALESE DNP (PMHNP FNP)
- **Authorized official phone:** (623) 313-6573

## Contact information

- **Practice address:** 18001 N 79TH AVE STE C61, GLENDALE, AZ 85308-6038
- **Practice address phone:** (623) 224-2403
- **Practice address fax:** (623) 267-0591
- **Mailing address:** 9627 W POTTER DR, PEORIA, AZ 85382-5157
- **Mailing address phone:** (623) 313-6573

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 09/05/2024
- **Last updated:** 03/11/2025