Organization
STARGATE BEHAVIORAL HEALTH SERVICES LLC
Active
Parent organization
-
Organization subpart
Yes
Provider details
NPI number
Legal business name
-
Authorized official
SEKOU A DONZO MALIKEE SONIE (CO OWNER/ADMINISTRATOR)
(216) 630-9350
Entity
Organization
Contact information
Practice address
7346 N 72ND AVE, GLENDALE, AZ 85303-1602
(216) 630-9350
(602) 581-3000
Mailing address
7346 N 72ND AVE, GLENDALE, AZ 85303-1602
(216) 630-9350
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/29/2020
Last updated
12/29/2020
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