Organization
GLORIA'S HOUSE OF HEALING
Active
Other names
Gloria's House
Organization subpart
No
Provider details
NPI number
Authorized official
DELIA CONSENTINO LISAC (CEO)
(623) 256-0021
Entity
Organization
Contact information
Practice address
2022 N PACEY RD, PHOENIX, AZ 85037-6301
(623) 256-0021
Mailing address
2022 N PACEY RD, PHOENIX, AZ 85037-6301
(623) 256-0021
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
—
—
Other
Enumeration date
12/15/2022
Last updated
12/15/2022
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