Organization Active NPI

Glory Treatment Center LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Phoenix, AZ
National Provider Identifier
1679268262
Registry record updated Apr 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
GLORY TREATMENT CENTER LLC
Practice address
3104 W Glendale Ave Ste 10
Phoenix, AZ 85051-8317
Phone
(602) 516-4473
NPI assigned
Apr 10, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Habtom H Hadish
Title
Manager
Phone
(602) 516-4473

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

3104 W Glendale Ave Ste 10
Phoenix, AZ 85051-8317

Mailing address

9439 W Virginia Ave
Phoenix, AZ 85037-4433
Phone (602) 516-4473

National Provider Directory

National Provider Directory

Locations

3104 W Glendale Ave
Ste 10
Phoenix, AZ 85051
Phone (602) 516-4473

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1681084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681084800000",
    "number": "1679268262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9439 W VIRGINIA AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850374433",
            "telephone_number": "602-516-4473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3104 W GLENDALE AVE STE 10",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850518317",
            "telephone_number": "602-516-4473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLORY TREATMENT CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-10",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-09",
        "status": "A",
        "authorized_official_last_name": "HADISH",
        "authorized_official_first_name": "HABTOM",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "602-516-4473"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.