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Organization

OPEN GATE HEALTH LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EDWINA JOHNSON (OWNER)
(914) 338-6145
Entity
Organization

Contact information

Practice address
7550 N 19TH AVE STE 204, PHOENIX, AZ 85021-7981
(602) 675-2507
Mailing address
7550 N 19TH AVE STE 204, PHOENIX, AZ 85021-7981
(602) 675-2507

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary

Other

Enumeration date
07/08/2022
Last updated
12/26/2024
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