Provider Demographics
NPI:1396459194
Name:ANOTHER HALLWAY 2 HEART LLC
Entity type:Organization
Organization Name:ANOTHER HALLWAY 2 HEART LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:FULLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-483-5441
Mailing Address - Street 1:2550 W UNION HILLS DR STE 350
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-5187
Mailing Address - Country:US
Mailing Address - Phone:702-483-5441
Mailing Address - Fax:702-483-5431
Practice Address - Street 1:2550 W UNION HILLS DR STE 350
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-5187
Practice Address - Country:US
Practice Address - Phone:702-483-5441
Practice Address - Fax:702-483-5431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-06
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health