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General NPI Number Information
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NPI Number | 1710663430
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Entity Type | Organization
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Legal Business Name | 180 MENTAL HEALTH AND WELLNESS, LLC.
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Dates
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Enumeration Date | 06/26/2023
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Last Update Date | 01/23/2024
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Provider Practice Location Address
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Address Line | 3404 W CHERYL DR STE A150
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City | PHOENIX
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State | AZ
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Zip | 85051-9615
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Country | US
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Telephone | 480-863-5250
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Fax | 480-896-2254
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Provider Business Mailing Address
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Address Line | 9855 E SOUTHERN AVE # 50729
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City | MESA
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State | AZ
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Zip | 85209-3801
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Country | US
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Telephone | 480-721-7055
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ANGELA STUFF
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Credential | FNP, PMHNP
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Telephone | 480-721-7055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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