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Organization

BEST SELF LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. NICOLE GORDON LCSW (OWNER)
(480) 295-6181
Entity
Organization

Contact information

Practice address
10000 N 31ST AVE STE C100-128, PHOENIX, AZ 85051-1356
(480) 295-6181
Mailing address
7609 W ROVEY AVE, GLENDALE, AZ 85303-4250
(480) 295-6181

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
261QM0855X
Adolescent and Children Mental Health Clinic/Center

Other

Enumeration date
10/24/2020
Last updated
10/24/2020
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