Provider Demographics
NPI:1578207551
Name:HARMONY HEIGHTS FOUNDATION LLC
Entity Type:Organization
Organization Name:HARMONY HEIGHTS FOUNDATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:OGU
Authorized Official - Suffix:
Authorized Official - Credentials:RN-BSN
Authorized Official - Phone:480-803-5161
Mailing Address - Street 1:1220 E GLASS LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85042-5971
Mailing Address - Country:US
Mailing Address - Phone:480-803-5161
Mailing Address - Fax:
Practice Address - Street 1:1220 E GLASS LN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85042-5971
Practice Address - Country:US
Practice Address - Phone:480-803-5161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-25
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health