CHANCELLOR HOUSE LLC NPI 1093304479

NPI Information

NPI: 1093304479
Provider Name: CHANCELLOR HOUSE, LLC
Classification: Clinic/Center - 261QM0850X
Entity Type: Organization

Specialization: Adult Mental Health

Address:
5060 N 19TH AVE STE 214
PHOENIX, AZ
ZIP 85015
Phone: (480) 561-7895
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CHANCELLOR HOUSE, LLC is an adult mental health clinic center in Phoenix, AZ. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. CHANCELLOR HOUSE, LLC NPI is 1093304479. The provider is registered as an organization entity type.

The provider's business location address is:

5060 N 19TH AVE STE 214
PHOENIX, AZ
ZIP 85015-212
Phone: (480) 561-7895

The provider's authorized official is Milissa Andrea Winston .
The authorized official title is Clinical Director and has the following contact phone number (480) 561-7895.

The enumeration date for this NPI number is 1/11/2021 and was last updated on 1/11/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0850X	Clinic/Center	Adult Mental Health			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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