Organization
GIFT OF HEARTS HOME III, LLC
Active
Other names
Gift of hearts home
Organization subpart
No
Provider details
NPI number
Authorized official
MICHEL GAHAKANYI (CHIEF EXECUTIVE OFFICER)
(605) 413-0143
Entity
Organization
Contact information
Practice address
2529 N 88TH LN, PHOENIX, AZ 85037-3412
(480) 466-3852
Mailing address
2529 N 88TH LN, PHOENIX, AZ 85037-3412
(480) 466-3852
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
BH6900
—
AZ
Enumeration date
07/22/2021
Last updated
07/22/2021
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