Organization
GRAND CANYON BEHAVIOR HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVELYNE NDERA (OWNER)
(602) 900-3506
Entity
Organization
Contact information
Practice address
3215 E FLOWER ST, PHOENIX, AZ 85018-6329
(602) 900-3506
Mailing address
3215 E FLOWER ST, PHOENIX, AZ 85018-6329
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/31/2023
Last updated
03/31/2023
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