Provider Demographics
NPI:1932811171
Name:NOAH'S HOPE WELLNESS CENTER
Entity Type:Organization
Organization Name:NOAH'S HOPE WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:GISENDANER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-577-8389
Mailing Address - Street 1:2920 N 24TH AVE STE 260
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-5961
Mailing Address - Country:US
Mailing Address - Phone:702-577-8389
Mailing Address - Fax:
Practice Address - Street 1:2920 N 24TH AVE STE 260
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-5961
Practice Address - Country:US
Practice Address - Phone:702-577-8389
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-20
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health