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General NPI Number Information
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NPI Number | 1245943729
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Entity Type | Organization
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Legal Business Name | BIG HEARTS LLC
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Dates
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Enumeration Date | 12/29/2022
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Last Update Date | 12/29/2022
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Provider Practice Location Address
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Address Line | 10426 W PIMA ST
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City | TOLLESON
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State | AZ
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Zip | 85353-1362
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Country | US
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Telephone | 623-215-2159
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Fax | 623-248-5400
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Provider Business Mailing Address
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Address Line | 10426 W PIMA ST
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City | TOLLESON
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State | AZ
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Zip | 85353-1362
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Country | US
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Telephone | 623-215-2159
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Fax | 623-248-5400
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Authorized Official
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Title or Position | CEO - ADMINISTRATOR
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Name | MRS. ADENIKE IBIYEMI-ALUKO
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Credential | BACHELORS; MASTERS
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Telephone | 623-521-3420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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