Immanuel Behavioral Health Counseling Clinic
LBN: Immanuel Behavioral Health Counseling Clinic
Immanuel Behavioral Health Counseling Clinic is an health care organization with primary practice located at 11301 N 99Th Ave Ste 5120 , Peoria AZ 85345-5485. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty.
Immanuel Behavioral Health Counseling Clinic can be contacted via phone (623) 876-6379, or through Pierce, Brenda Kay via phone (623) 738-8549.
Contact Information
Primary practice address
11301 N 99Th Ave Ste 5120
Peoria AZ 85345-5485
Phone: (623) 876-6379
Fax: (623) 876-6379
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Ambulatory Health Care Facilities / Clinic/Center | 261Q00000X |
Profile Details
NPI number | 1104495084 |
---|---|
LBN Legal business name | Immanuel Behavioral Health Counseling Clinic |
DBA Doing business as | |
Authorized official | Pierce, Brenda Kay MD MA |
Entity | Organization |
Organization subpart 1 | Yes |
Enumeration date | Jun 23rd, 2021 |
Last updated | Apr 27th, 2023 - about last year |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1104495084 | NPPES |
Arizona | MEDICAID | 447591 |
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