| Eternity Services LLC | |
|
2200 W Bethany Home Rd Ste 1 Phoenix AZ 85015-1937 | |
| (602) 601-4104 | |
| Not Available |
| Full Name | Eternity Services LLC |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2200 W Bethany Home Rd Ste 1, Phoenix, Arizona |
| Authorized Official Name and Position | Derrick Montgomery (MANAGING PARTNER) |
| Authorized Official Contact | 6026215126 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eternity Services LLC 2925 W Myrtle Ave Phoenix AZ 85051-7538 Ph: (602) 621-5126 | Eternity Services LLC 2200 W Bethany Home Rd Ste 1 Phoenix AZ 85015-1937 Ph: (602) 601-4104 |
| NPI Number | 1013646678 |
|---|---|
| Provider Enumeration Date | 06/08/2022 |
| Last Update Date | 06/08/2022 |
| Certification Date | 06/08/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013646678 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | () | Primary |
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