Abundant Grace LLC
Community/Behavioral Health in Phoenix, Arizona
1316644636- Practice location
- 7227 S Central Ave, #1080, Phoenix, AZ 85042-2951
- Phone
- 623-521-5935
- Fax
- 602-441-4838
- Last updated
- February 8, 2023
Abundant Grace LLC is a healthcare organization based in Phoenix, AZ. The NPI number for Abundant Grace LLC is 1316644636. The current practice location address is 7227 S Central Ave, #1080, Phoenix, AZ 85042-2951 and the office can be reached by phone at 623-521-5935 and by fax at 602-441-4838. The NPI was assigned on February 8, 2023 and the record was last updated in NPPES on February 8, 2023.
●Provider Profile Details
- NPI Number
- 1316644636
- Provider Name
- Abundant Grace LLC
- Entity Type
- Organization (Type 2 NPI)
- Primary Taxonomy
- Community/Behavioral Health · 251S00000X
- Organization Subpart
- No
- Authorized Official
- Olufemi Omodara, RPH · Owner · 623-521-5935
- Enumeration Date
- February 8, 2023
- Last Update Date
- February 8, 2023
- Certification Date
- February 8, 2023
- NPI Status
- Active
- Other Names
- Khen Behavioral Clinic (Doing Business As)
◉Business Practice Location Address
- Address
- 7227 S Central Ave
#1080
Phoenix, AZ 85042-2951 - City
- Phoenix
- State
- Arizona
- ZIP
- 85042-2951
- Country
- US
- Phone Number
- 623-521-5935
- Fax Number
- 602-441-4838
✉Business Mailing Address
- Address
- P.o. Box 5693
Goodyear, AZ 85338 - City
- Goodyear
- State
- AZ
- ZIP
- 85338
- Phone Number
- 623-521-5935
- Fax Number
- 602-441-4838
✎Taxonomy & License Information
| Taxonomy | Code | Primary | License | State |
|---|---|---|---|---|
| Community/Behavioral Health | 251S00000X | Yes | — | — |
#Other Provider Identifiers
No legacy or other identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.
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View all providers in Phoenix →?Frequently Asked Questions
What is the NPI number of Abundant Grace LLC?
The NPI number of Abundant Grace LLC is 1316644636. It was assigned on February 8, 2023 and is currently active in the NPPES registry.
What is the specialty of Abundant Grace LLC?
Abundant Grace LLC is registered under the primary taxonomy Community/Behavioral Health (code 251S00000X).
Where does Abundant Grace LLC practice?
The practice location is 7227 S Central Ave, #1080, Phoenix, AZ 85042-2951. The office can be reached at 623-521-5935 (phone) or 602-441-4838 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1316644636 directly on the NPPES registry website at npiregistry.cms.hhs.gov.