Organization
ROSS & MACKENZIE LLC
Active
Other names
Agape Family Services
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WAYNE M MACKENZIE SR. PMHNP-BC (CEO)
(623) 224-1162
Entity
Organization
Contact information
Practice address
319 N LITCHFIELD RD STE 105, GOODYEAR, AZ 85338-1256
(623) 224-1162
Mailing address
319 N LITCHFIELD RD, SUITE 105, GOODYEAR, AZ 85338-1256
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
106H00000X
Marriage & Family Therapist
—
—
2084P0800X
Psychiatry Physician
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PDZ-0000000-27067
—
AZ
01
—
QXIPQ0000098776
AHCCCS
AZ
Enumeration date
11/01/2014
Last updated
07/23/2024
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