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Organization
GOSHEN METHADONE CLINIC
Active
Organization
GOSHEN METHADONE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OSWALD NKENGURUKIYIMANA (OWNER)
(602) 930-8671
Entity
Organization
Contact information
Practice address
2727 W GLENDALE AVE, PHOENIX, AZ 85051-8447
(602) 930-8671
Mailing address
2727 W GLENDALE AVE, PHOENIX, AZ 85051-8447
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
—
—
Other
Enumeration date
11/20/2023
Last updated
11/20/2023
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