Individual
OLIVER SSENKUBUGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5127 W MALDONADO RD, LAVEEN, AZ 85339-6918
(818) 310-6648
Mailing address
5127 W MALDONADO RD, LAVEEN, AZ 85339-6918
(818) 310-6648
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/10/2024
Last updated
12/10/2024
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