Organization
ABUNDANT GRACE LLC
Active
Other names
KHEN BEHAVIORAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
OLUFEMI OMODARA RPH (OWNER)
(623) 521-5935
Entity
Organization
Contact information
Practice address
7227 S CENTRAL AVE, #1080, PHOENIX, AZ 85042-2951
(623) 521-5935
(602) 441-4838
Mailing address
P.O. BOX 5693, GOODYEAR, AZ 85338
(623) 521-5935
(602) 441-4838
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/08/2023
Last updated
02/08/2023
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