Angel Heart Behavioral Health V , LLC
Organization Active NPI Mental Illness Community Based Residential Treatment Facility · Tolleson, AZ
NPI 1295323095 · NPPES record last updated Jan 6, 2021
Key facts
- NPI
- 1295323095
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Illness Community Based Residential Treatment Facility 320800000X
- Legal business name
- ANGEL HEART BEHAVIORAL HEALTH V , LLC
- Practice address
- 3909 S 103Rd Dr
Tolleson, AZ 85353-4187 - Phone
- (207) 409-6515
- NPI assigned
- Jan 6, 2021
- Organization subpart
- No
Authorized official
- Name
- Mr. Eric Nibizi Sr.
- Title
- Ceo
- Phone
- (207) 409-6515
Corporate family (same tax ID) 3
National Provider Directory
- Tax ID family
- Angel Heart Behavavioral Health
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Illness Community Based Residential Treatment Facility | 320800000X | Yes |
Addresses
Primary practice location
3909 S 103Rd Dr
Tolleson, AZ 85353-4187
Mailing address
3909 S 103Rd Dr
Tolleson, AZ 85353-4187
Phone (207) 409-6515
Other names
- ANGEL HEART BEHAVIORAL HEALTH V
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All providers in Tolleson, AZ · Mental Illness Community Based Residential Treatment Facility in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 6, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.