Individual
KODZO HONU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5234 S 236TH AVE, BUCKEYE, AZ 85326-7284
(520) 585-7143
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
BH10347
AZ
385H00000X
Respite Care
BH10347
AZ
Other
Enumeration date
12/04/2024
Last updated
12/04/2024
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