Organization
HEART OF CARE INTEGRATED CLINIC INC
Active
Organization
HEART OF CARE INTEGRATED CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS WILDINE BURGESS (EXEC ADMIN)
(240) 350-2863
Entity
Organization
Contact information
Practice address
3930 E RAY RD STE 120, PHOENIX, AZ 85044-7172
(602) 354-9252
Mailing address
PO BOX 51382, PHOENIX, AZ 85076-1382
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
10/05/2022
Last updated
12/05/2024
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