03D2284214 CLIA NUMBER - HEALTHY MINDS BEHVAIORAL HEALTH LLC

Laboratory Demographics

CLIA Number: 03D2284214

Facility Name: HEALTHY MINDS BEHVAIORAL HEALTH LLC

Facility Address:
1114 W MCDOWELL RD
PHOENIX, AZ
ZIP 85007
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Facility Phone Number: 602 334-1041

Facility Type: Other - OUTPATIENT BEHAVIORAL

Certificate Type: Waiver

NPI Number: 1417642091

Taxonomy: 261QM0850X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.

CLIA Record

Field Name	Field Value
CLIA Number	03D2284214
LAB Type	Other - OUTPATIENT BEHAVIORAL
Facility Name	HEALTHY MINDS BEHVAIORAL HEALTH LLC
Street	1114 W MCDOWELL RD
City	PHOENIX
State	AZ
ZIP	85007
Phone	602 334-1041
CertificateType	4
CertificateEffectiveDate	6/20/2023
CertificateExpirationDate	6/19/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024