Individual
MR. FREDDY SISANGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3028 S 66TH LN, PHOENIX, AZ 85043-5714
(602) 540-0437
Mailing address
3028 S 66TH LN, PHOENIX, AZ 85043-5714
(602) 540-0437
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
06/22/2023
Last updated
06/22/2023
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