Organization
ANGEL HEART BEHAVIORAL HEALTH II LLC
Active
Other names
ANGEL HEART BEHAVIORAL HEALTH II LLC
Organization subpart
No
Provider details
NPI number
Authorized official
AIMEE NYIRAKANYANA (CEO)
(207) 409-6515
Entity
Organization
Contact information
Practice address
7432 W GLENROSA AVE, PHOENIX, AZ 85033-2518
(207) 409-6515
Mailing address
7432 W GLENROSA AVE, PHOENIX, AZ 85033-2518
(207) 409-6515
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
BH5941
—
AZ
Enumeration date
12/09/2019
Last updated
12/09/2019
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