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Organization
GRAND CANYON PSYCHIATRIC SERVICES PLLC
Active
Organization
GRAND CANYON PSYCHIATRIC SERVICES PLLC
Active
Other names
Grand Canyon Psychiatric Services
Organization subpart
No
Provider details
NPI number
Authorized official
PETER NJOGU APRN (CEO)
(316) 371-9196
Entity
Organization
Contact information
Practice address
28581 N CLOVER CIR, SAN TAN VALLEY, AZ 85143-5869
(316) 371-9196
Mailing address
28581 N CLOVER CIR, SAN TAN VALLEY, AZ 85143-5869
(316) 371-9196
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/03/2023
Last updated
11/28/2023
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