Organization
HOPE LIGHT CARE HOMES , LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL NDAYIRAGIJE (ADMINISTRATOR)
(480) 278-2047
Entity
Organization
Contact information
Practice address
9963 W MONTEROSA AVE, PHOENIX, AZ 85037-2510
(480) 278-2047
Mailing address
9963 W MONTEROSA AVE, PHOENIX, AZ 85037-2510
(480) 278-2047
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
03/02/2021
Last updated
03/25/2021
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