Active NPI
Glory Treatment Center LLC
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Phoenix, AZ
National Provider Identifier
1679268262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 DirectoryLocations
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.