| Successful Journeys Day Program | |
|
9950 W Van Buren St B135 Avondale AZ 85323-5322 | |
| (623) 478-9400 | |
| (623) 478-9500 |
| Full Name | Successful Journeys Day Program |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 9950 W Van Buren St, Avondale, Arizona |
| Authorized Official Name and Position | Sekou Jackson (CLINICAL DIRECTOR/COO) |
| Authorized Official Contact | 6234789400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Successful Journeys Day Program 9950 W Van Buren St B135 Avondale AZ 85323-5322 Ph: (623) 478-9400 | Successful Journeys Day Program 9950 W Van Buren St B135 Avondale AZ 85323-5322 Ph: (623) 478-9400 |
| NPI Number | 1003180746 |
|---|---|
| Provider Enumeration Date | 02/27/2012 |
| Last Update Date | 02/27/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003180746 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | BH3967 (Arizona) | Primary |
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