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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