Organization
HOME OF GRACE COUNSELING ARIZONA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TEODOSIO GUTIERREZ (DIRECTOR OF OUTPATIENT SERVICES)
(480) 757-7952
Entity
Organization
Contact information
Practice address
4700 S MILL AVE STE 5, TEMPE, AZ 85282-6736
(480) 757-7952
Mailing address
4700 S MILL AVE STE 5, TEMPE, AZ 85282-6736
(480) 757-7952
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/12/2023
Last updated
08/16/2024
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