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Organization

PASTALINO MANOR LLC 2

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. PAUL MUNYAO KIVILA BA (ADMINISTRATOR)
(480) 634-5485
Entity
Organization

Contact information

Practice address
1383 W KESLER LN, CHANDLER, AZ 85224-7289
(480) 634-5485
(480) 699-7288
Mailing address
1393 W KESLER LN, CHANDLER, AZ 85224-7229
(480) 634-5485
(480) 699-7288

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
BH 4431
AZ
320800000X
Mental Illness Community Based Residential Treatment Facility
BH 4431
AZ

Other

Enumeration date
03/24/2015
Last updated
03/24/2015
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