Individual
KELECHI ONWUCHEKWA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9005 W VERNON AVE, PHOENIX, AZ 85037-3637
(602) 472-0105
Mailing address
12228 W PIMA ST, AVONDALE, AZ 85323-8105
(602) 472-0105
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
323P00000X
Psychiatric Residential Treatment Facility
—
—
Other
Enumeration date
12/10/2020
Last updated
01/06/2023
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