Organization
ANGEL HEART BEHAVIORAL HEALTH LLC
Active
Other names
ANGEL HEART BEHAVIORAL HEALTH
Organization subpart
No
Provider details
NPI number
Authorized official
AIMEE N NYIRAKANYANA (ADMINISTRATOR)
(207) 409-6515
Entity
Organization
Contact information
Practice address
11114 W COLLEGE DR, PHOENIX, AZ 85037-1269
(207) 409-6515
(623) 777-0427
Mailing address
11114 W COLLEGE DR, PHOENIX, AZ 85037-1269
(207) 409-6515
(623) 777-0427
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00000
—
AZ
Enumeration date
05/08/2018
Last updated
05/08/2018
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