Individual
BAHATI BAKANGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
23835 W HIDALGO AVE, BUCKEYE, AZ 85326-7008
(702) 465-7946
Mailing address
4000 N CENTRAL AVE STE 100, PHOENIX, AZ 85012-3520
(602) 859-7794
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
BH10421
AZ
385H00000X
Respite Care
BH10421
AZ
Other
Enumeration date
02/17/2025
Last updated
02/17/2025
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