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Organization
AZI HOUSE LLC
Active
Organization
AZI HOUSE LLC
Active
Other names
Azi House one
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL ATABONGNKENG FUANGUNYI (STATUTORY AGENT)
(240) 643-0815
Entity
Organization
Contact information
Practice address
6914 S BITTERCRESS RD, TUCSON, AZ 85756
(240) 643-0815
Mailing address
5986 S JAKEMP TRL, TUCSON, AZ 85747-6003
(240) 643-0815
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
NULL
Other
Enumeration date
11/15/2009
Last updated
12/27/2019
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