MEDICARE: GUARDIAN ANGELS BEHAVIORAL HEALTH PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1144186826
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUARDIAN ANGELS BEHAVIORAL HEALTH PLLC

Provider Business Mailing Address
First Line	:	709 S 122ND AVE
Second Line	:
City	:	AVONDALE
State	:	AZ
Zip	:	85323-8419
Country	:	US
Telephone Number	:	520-528-8062
Fax Number	:

Provider Business Practice Location Address
First Line	:	709 S 122ND AVE
Second Line	:
City	:	AVONDALE
State	:	AZ
Zip	:	85323-8419
Country	:	US
Telephone Number	:	520-528-8062
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MOHAMED AID
Credential	:
Telephone Number	:	520-528-8062

Provider Enumeration Date	:	12/26/2025
Last Update Date	:	12/26/2025

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