| Avenue To Hope Llc | |
|
4106 W Beverly Rd Laveen AZ 85339-2534 | |
| (602) 750-0749 | |
| Not Available |
| Full Name | Avenue To Hope Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4106 W Beverly Rd, Laveen, Arizona |
| Authorized Official Name and Position | Shasa Lynn Jackson (OWNER/MANAGING MEMBER) |
| Authorized Official Contact | 6027500749 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Avenue To Hope Llc 4106 W Beverly Rd Laveen AZ 85339-2534 Ph: (602) 750-0749 | Avenue To Hope Llc 4106 W Beverly Rd Laveen AZ 85339-2534 Ph: (602) 750-0749 |
| NPI Number | 1922925361 |
|---|---|
| Provider Enumeration Date | 07/06/2026 |
| Last Update Date | 07/06/2026 |
| Certification Date | 07/05/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922925361 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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