Organization
ABSOLUTE CARE LLC
Active
Other names
Ark of Angel Behavioral Home
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDY MALLARI OMD, MSN, BA, RN (CLINICAL DIRECTOR - CNL)
(602) 888-2468
Entity
Organization
Contact information
Practice address
3842 E IRWIN AVE, MESA, AZ 85206-3852
(602) 394-2689
Mailing address
3842 E IRWIN AVE, MESA, AZ 85206-3852
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH6716
ARIZONA DEPARTMENT OF HEALTH SERVICES
AZ
Enumeration date
07/16/2021
Last updated
07/16/2021
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