Organization
MY BROTHERS KEEPER
Active
Other names
MBK
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JACQUELINE PERRIE PM (ADMINISTRATOR)
(480) 265-8816
Entity
Organization
Contact information
Practice address
4425 E AGAVE RD STE 102, PHOENIX, AZ 85044-0620
(480) 265-8816
Mailing address
4425 E AGAVE RD STE 102, PHOENIX, AZ 85044-0620
(480) 265-8816
Taxonomy
Speciality
Code
Description
License number
State
101200000X
Drama Therapist
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP1600X
Pastoral Counselor
—
—
101YP2500X
Professional Counselor
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172A00000X
Driver
—
—
175T00000X
Peer Specialist
Primary
—
—
177F00000X
Lodging Provider
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
347C00000X
Private Vehicle
—
—
405300000X
Prevention Professional
—
—
Other
Enumeration date
11/07/2023
Last updated
11/20/2023
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