Organization
PHOENIX GOSPEL MISSION, INC. DBA PHOENIX RESCUE MISSION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATHAN A. SMITH (CHIEF PROGRAM OFFICER)
(602) 419-8194
Entity
Organization
Contact information
Practice address
1801 S 35TH AVE, PHOENIX, AZ 85009-6706
(602) 233-3000
(602) 272-5614
Mailing address
1540 W VAN BUREN ST, PHOENIX, AZ 85007-2414
(602) 233-3000
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/19/2018
Last updated
10/17/2023
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