Organization
CROWN BEHAVIORAL INTEGRATED CLINIC
Active
Organization
CROWN BEHAVIORAL INTEGRATED CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAURICE MBARUSHIMANA (ADMINISTRATOR)
(602) 312-1334
Entity
Organization
Contact information
Practice address
6619 N 19TH AVE STE C1, PHOENIX, AZ 85015-1631
(480) 214-5886
Mailing address
6619 N 19TH AVE STE C1, PHOENIX, AZ 85015-1631
(480) 214-5886
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
05/02/2025
Last updated
09/28/2025
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