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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