Organization
HEAVENLY BEHAVIORAL HOMES LLC
Active
Organization
HEAVENLY BEHAVIORAL HOMES LLC
Active
Other names
HEAVENLY BEHAVIORAL HOME LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA CELIA DELA CRUZ (OWNER)
(623) 235-7871
Entity
Organization
Contact information
Practice address
4209 W IRWIN AVE, PHOENIX, AZ 85041-6089
(623) 235-7871
Mailing address
4209 W IRWIN AVE, PHOENIX, AZ 85041-6089
(623) 235-7871
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
04/03/2020
Last updated
09/28/2020
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