Healthcare Provider Details

I. General information

NPI: 1235094525
Provider Name (Legal Business Name): HEARTS TURN HEALING AND RECOVERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

515 W BUCKEYE RD
PHOENIX AZ
85003-2647
US

IV. Provider business mailing address

2045 E MYRTLE AVE
PHOENIX AZ
85020-5639
US

V. Phone/Fax

Practice location:
  • Phone: 602-814-2794
  • Fax:
Mailing address:
  • Phone: 602-814-2794
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: YUSOUF ATALLA
Title or Position: CEO
Credential:
Phone: 602-814-2794