Organization
MERCY THEN GRACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LATOYA R SIBLEY MS, BHT (CLINICAL OPERATIONS DIRECTOR)
(602) 826-5636
Entity
Organization
Contact information
Practice address
4701 N 26TH LN, PHOENIX, AZ 85017-3609
(602) 826-5636
Mailing address
4600 E WASHINGTON ST STE 300, PHOENIX, AZ 85034-1908
(602) 826-5636
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Enumeration date
05/17/2023
Last updated
05/17/2023
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