Organization
CHANCELLOR HOUSE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MILISSA ANDREA WINSTON MHS, LASAC (CLINICAL DIRECTOR)
(480) 561-7895
Entity
Organization
Contact information
Practice address
5060 N 19TH AVE STE 214, PHOENIX, AZ 85015-3212
(480) 561-7895
Mailing address
889 N COFCO CENTER CT UNIT 1151, PHOENIX, AZ 85008-6453
(480) 561-7895
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
01/11/2021
Last updated
01/11/2021
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