Organization
STARGATE BEHAVIORAL HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SEKOU A DONZO (CEO)
(216) 630-9350
Entity
Organization
Contact information
Practice address
1924 W ALTA VISTA RD, PHOENIX, AZ 85041-5443
(901) 652-8154
Mailing address
1924 W ALTA VISTA RD, PHOENIX, AZ 85041-5443
(901) 652-8154
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/03/2019
Last updated
01/28/2020
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