A Willows Grace
Clinic/Center, Mental Health (Including Community Mental Health Center) in Mesa, AZ. Organization (NPI-2).
NPI number1366114852
StatusActive
Last updated in NPPESMar 30, 2022
Details
- NPI
- 1366114852
- Entity type
- Organization (NPI-2)
- Legal business name
- A Willows Grace
- Organization subpart
- No
- Enumeration date
- Oct 2, 2021
- Certification date
- Mar 30, 2022
- Last updated
- Mar 30, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | Yes |
Practice location
1220 S Alma School Rd Ste 103Mesa, AZ 85210-2078
Phone 602-291-7364
Mailing address
Po Box 40382Mesa, AZ 85274-0382
Authorized official
Crystal Bennett
Owner
6022917364
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