| Divine Heart Llc | |
|
1650 W Southern Ave Ste 3 Phoenix AZ 85041-4627 | |
| (520) 208-1970 | |
| Not Available |
| Full Name | Divine Heart Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1650 W Southern Ave Ste 3, Phoenix, Arizona |
| Authorized Official Name and Position | Forster Okoli (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 5202081970 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Divine Heart Llc 21903 S 187th Way Queen Creek AZ 85142-6463 Ph: (652) 020-8197 | Divine Heart Llc 1650 W Southern Ave Ste 3 Phoenix AZ 85041-4627 Ph: (520) 208-1970 |
| NPI Number | 1902567084 |
|---|---|
| Provider Enumeration Date | 01/01/2022 |
| Last Update Date | 03/14/2023 |
| Certification Date | 03/14/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902567084 | NPI | - | NPPES |
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