Healthcare Provider Details

I. General information

NPI: 1780207357
Provider Name (Legal Business Name): WHOLENESS 2 PEACE CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2020
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10000 N 31ST AVE STE A105
PHOENIX AZ
85051-9568
US

IV. Provider business mailing address

10000 N 31ST AVE STE A105
PHOENIX AZ
85051-9568
US

V. Phone/Fax

Practice location:
  • Phone: 623-688-1537
  • Fax: 602-761-9610
Mailing address:
  • Phone: 623-688-1537
  • Fax: 602-761-9610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: KATRINA BROWN HARRELL
Title or Position: OWNER
Credential: MSC, PLPC
Phone: 623-688-1537