Organization
MEMA HOMES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID MAGATI NYANCHIRI (CEO)
(763) 439-0368
Entity
Organization
Contact information
Practice address
4613 N 91ST DR, PHOENIX, AZ 85037-1322
(763) 439-0368
Mailing address
4613 N 91ST DR, PHOENIX, AZ 85037-1322
(763) 439-0368
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/04/2018
Last updated
10/04/2018
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