Organization
AMAZING GRACE HEALTH LLC
Active
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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