Organization
MON AMI GROUP HOME
Active
Other names
MonAmi Group home LLc
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SALIM OTIENO ODIERO (C.E.O)
(480) 380-4413
Entity
Organization
Contact information
Practice address
9138 E DENNIS ST, MESA, AZ 85207-6008
(480) 380-4413
(480) 530-5408
Mailing address
9138 E DENNIS ST, MESA, AZ 85207-6008
(480) 380-4413
(480) 530-5408
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/26/2019
Last updated
06/10/2020
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