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Organization

FACING THE FUTURE WITH HOPE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KIMARA BLACKMAN PH D (CEO/DIRECTOR)
(602) 795-5722
Entity
Organization

Contact information

Practice address
5656 N 17TH AVE #C7, PHOENIX, AZ 85015
(602) 795-5722
Mailing address
5656 N 17TH AVE #C7, PHOENIX, AZ 85015
(602) 795-5722

Taxonomy

Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
101YP2500X
Professional Counselor
102X00000X
Poetry Therapist
103K00000X
Behavior Analyst
171100000X
Acupuncturist
171M00000X
Case Manager/Care Coordinator
171W00000X
Contractor
Primary
172V00000X
Community Health Worker
2084P0802X
Addiction Psychiatry Physician
261Q00000X
Clinic/Center
261QC1500X
Community Health Clinic/Center
261QR1100X
Research Clinic/Center
320800000X
Mental Illness Community Based Residential Treatment Facility
323P00000X
Psychiatric Residential Treatment Facility
324500000X
Substance Abuse Rehabilitation Facility

Other

Enumeration date
10/31/2012
Last updated
10/31/2012
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