| Shalom Behavioral House, Llc | |
|
11063 W Virginia Ave Avondale AZ 85392-5889 | |
| (855) 895-0261 | |
| (855) 755-9202 |
| Full Name | Shalom Behavioral House, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 11063 W Virginia Ave, Avondale, Arizona |
| Authorized Official Name and Position | Aime Mukura Linda Minega Shabani (MANAGER) |
| Authorized Official Contact | 8558950261 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shalom Behavioral House, Llc 8050 N 19th Ave Unit 151 Phoenix AZ 85021-5160 Ph: (855) 895-0261 | Shalom Behavioral House, Llc 11063 W Virginia Ave Avondale AZ 85392-5889 Ph: (855) 895-0261 |
| NPI Number | 1366101479 |
|---|---|
| Provider Enumeration Date | 12/16/2021 |
| Last Update Date | 12/16/2021 |
| Certification Date | 12/16/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366101479 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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