Organization
AMAZING GRACE HEALTH LLC
Active
Other names
Amazing Grace Health
Organization subpart
No
Provider details
NPI number
Authorized official
LEONARD IWUALA (CEO)
(623) 206-2311
Entity
Organization
Contact information
Practice address
17156 W TONTO ST, GOODYEAR, AZ 85338-1295
(623) 206-2311
Mailing address
17156 W TONTO ST, GOODYEAR, AZ 85338-1295
(623) 206-2311
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
10/04/2021
Last updated
10/04/2021
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