Organization
ECLIPSE PSYCHIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY KIMANI PMHNP (PRESIDENT)
(978) 697-0301
Entity
Organization
Contact information
Practice address
2152 S VINEYARD UNIT 113-114, MESA, AZ 85210-6871
(623) 282-2047
Mailing address
2152 S VINEYARD, MESA, AZ 85210-6871
(978) 697-0301
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295370401
—
AZ
Enumeration date
06/10/2021
Last updated
05/24/2022
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