Organization
ACTIVE INTEGRATED HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRYCE BELLUE (PART OWNER)
(623) 505-8198
Entity
Organization
Contact information
Practice address
12402 W SOLEDAD ST, EL MIRAGE, AZ 85335-7244
(623) 262-8239
Mailing address
12402 W SOLEDAD ST, EL MIRAGE, AZ 85335-7244
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
09/17/2021
Last updated
09/17/2021
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