Healthcare Provider Details

I. General information

NPI: 1235810839
Provider Name (Legal Business Name): OUR LOVING HANDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2023
Last Update Date: 08/03/2023
Certification Date: 08/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15410 N 67TH AVE STE 8
GLENDALE AZ
85306-2830
US

IV. Provider business mailing address

15410 N 67TH AVE STE 8
GLENDALE AZ
85306-2830
US

V. Phone/Fax

Practice location:
  • Phone: 623-418-9747
  • Fax:
Mailing address:
  • Phone: 623-418-9747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: OMEGA ALAMIN
Title or Position: OWNER
Credential:
Phone: 623-418-9747