Organization
HASSAYAMPA CENTER FOR FAMILIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA L GATES LCSW (OWNER)
(203) 449-0972
Entity
Organization
Contact information
Practice address
510 W SAVAGE ST, WICKENBURG, AZ 85390-2206
(203) 449-0972
(480) 383-6356
Mailing address
515 DESERT CANYON RD, WICKENBURG, AZ 85390-3360
(203) 449-0972
(480) 383-6356
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LCSW-12968
AZ
Other
Enumeration date
02/26/2016
Last updated
03/10/2016
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