Organization
OPEN HEARTS
Active
Organization
OPEN HEARTS
Active
Other names
Youth Evaluation & Treatment Centers
Organization subpart
No
Provider details
NPI number
Authorized official
ROSE LOPEZ MBA (PRESIDENT AND CEO)
(520) 721-1887
Entity
Organization
Contact information
Practice address
4414 N 19TH AVE, PHOENIX, AZ 85015
(602) 285-5550
(602) 285-5551
Mailing address
PO BOX 86537, TUCSON, AZ 85754-6537
(520) 721-1887
(520) 721-0069
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
BH-1794
AZ
101YA0400X
Addiction (Substance Use Disorder) Counselor
BH-1794
AZ
101YM0800X
Mental Health Counselor
BH-1794
AZ
104100000X
Social Worker
BH-1794
AZ
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
349127
—
AZ
01
—
OTC6007
ADHS
AZ
Enumeration date
08/31/2006
Last updated
11/19/2025
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