# KINGDOM BEHAVIOR CARE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336839521
- **Authorized official:** MR. RONALD NKUSI (OWNER)
- **Authorized official phone:** (469) 455-4874

## Contact information

- **Practice address:** 3048 E BASELINE RD STE 101, MESA, AZ 85204-7287
- **Practice address phone:** (469) 455-4874
- **Mailing address:** 3048 E BASELINE RD STE 101, MESA, AZ 85204-7287
- **Mailing address phone:** (469) 455-4874

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | — |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 05/10/2023
- **Last updated:** 05/10/2023