| Divine Hope Iop, Llc | |
|
1917 W Glendale Ave Ste 8 Phoenix AZ 85021-7861 | |
| (480) 501-0957 | |
| Not Available |
| Full Name | Divine Hope Iop, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1917 W Glendale Ave Ste 8, Phoenix, Arizona |
| Authorized Official Name and Position | Yvonne Bahati (CEO) |
| Authorized Official Contact | 4805010957 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Divine Hope Iop, Llc 1917 W Glendale Ave Ste 8 Phoenix AZ 85021-7861 Ph: (480) 501-0957 | Divine Hope Iop, Llc 1917 W Glendale Ave Ste 8 Phoenix AZ 85021-7861 Ph: (480) 501-0957 |
| NPI Number | 1194500124 |
|---|---|
| Provider Enumeration Date | 08/28/2023 |
| Last Update Date | 08/28/2023 |
| Certification Date | 08/28/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194500124 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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