Organization
MON AMI 2 GROUP HOME LLC
Active
Other names
MON AMI 2 GROUP HOME
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SALIM OTIENO ODIERO BHT (CEO)
(602) 677-6359
Entity
Organization
Contact information
Practice address
40975 W MARY LOU DR, MARICOPA, AZ 85138-5433
(602) 677-6359
(480) 530-5408
Mailing address
40975 W MARY LOU DR, MARICOPA, AZ 85138-5433
(602) 677-6359
(480) 530-5408
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/14/2022
Last updated
06/14/2022
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