Organization
ANGIE'S LLC
Active
Other names
Goodyear home
Organization subpart
No
Provider details
NPI number
Authorized official
MISS MIREILLE MUKIZA MBA (CAO)
(623) 792-0191
Entity
Organization
Contact information
Practice address
16796 W PIERCE ST, GOODYEAR, AZ 85338-6167
(623) 215-2767
(623) 215-2927
Mailing address
16796 W PIERCE ST, GOODYEAR, AZ 85338-6167
(623) 792-0191
(623) 215-2927
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/09/2020
Last updated
12/09/2020
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