Organization
GRACE BEHAVIORAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA CROSS (VICE PRESIDENT)
(602) 231-0102
Entity
Organization
Contact information
Practice address
2336 E MAGNOLIA ST, PHOENIX, AZ 85034-6819
(602) 231-0102
(602) 231-0015
Mailing address
2336 E MAGNOLIA ST, PHOENIX, AZ 85034-6819
(602) 231-0102
(602) 231-0015
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
—
—
341600000X
Ambulance
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
347E00000X
Transportation Broker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
971764
—
AZ
Enumeration date
03/17/2008
Last updated
03/17/2008
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