| Mitsrain's House Of Hope Llc | |
|
5744 N 41st Ave Phoenix AZ 85019-1814 | |
| (646) 899-5270 | |
| Not Available |
| Full Name | Mitsrain's House Of Hope Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 5744 N 41st Ave, Phoenix, Arizona |
| Authorized Official Name and Position | Deborah C Rousseau (SPECIALIST) |
| Authorized Official Contact | 6468995270 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mitsrain's House Of Hope Llc 5744 N 41st Ave Phoenix AZ 85019-1814 Ph: (646) 899-5270 | Mitsrain's House Of Hope Llc 5744 N 41st Ave Phoenix AZ 85019-1814 Ph: (646) 899-5270 |
| NPI Number | 1780293654 |
|---|---|
| Provider Enumeration Date | 07/27/2020 |
| Last Update Date | 07/27/2020 |
| Certification Date | 07/27/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780293654 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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