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Organization
IKAZE BEHAVIORAL CENTER LLC
Active
Organization
IKAZE BEHAVIORAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SAFIA SANDRA UWERA (ADMINISTRATOR)
(650) 420-9888
Entity
Organization
Contact information
Practice address
350 E DUNLAP AVE, PHOENIX, AZ 85020-2914
(650) 420-9888
Mailing address
350 E DUNLAP AVE, PHOENIX, AZ 85020-2914
(650) 420-9888
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
NULL
251S00000X
Community/Behavioral Health Agency
—
NULL
261QH0100X
Health Service Clinic/Center
—
NULL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
NULL
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
NULL
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
NULL
261QS1000X
Student Health Clinic/Center
—
NULL
385HR2055X
Child Mental Illness Respite Care
—
NULL
Other
Enumeration date
08/15/2023
Last updated
08/17/2023
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