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Organization
MIND 247 PRACTICE LLC
Active
Organization
MIND 247 PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AISHA LYNN DEPRIEST (DIRECTOR OF CREDENTIALING)
(480) 369-4008
Entity
Organization
Contact information
Practice address
2728 N 24TH ST, PHOENIX, AZ 85008-1050
(844) 646-3247
Mailing address
1465 N SCOTTSDALE RD STE 400, SCOTTSDALE, AZ 85257-3634
(844) 646-3247
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
06/03/2021
Last updated
10/04/2022
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