| Stargate Behavioral Health Services Llc | |
|
7346 N 72nd Ave Glendale AZ 85303-1602 | |
| (216) 630-9350 | |
| (602) 581-3000 |
| Full Name | Stargate Behavioral Health Services Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 7346 N 72nd Ave, Glendale, Arizona |
| Authorized Official Name and Position | Sekou A Donzo (CO OWNER/ADMINISTRATOR) |
| Authorized Official Contact | 2166309350 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stargate Behavioral Health Services Llc 7346 N 72nd Ave Glendale AZ 85303-1602 Ph: (216) 630-9350 | Stargate Behavioral Health Services Llc 7346 N 72nd Ave Glendale AZ 85303-1602 Ph: (216) 630-9350 |
| NPI Number | 1104413863 |
|---|---|
| Provider Enumeration Date | 12/29/2020 |
| Last Update Date | 12/29/2020 |
| Certification Date | 12/29/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104413863 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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