Organization
SWALEA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDITH MWANDAGA (ADMINISTRATOR)
(714) 858-1284
Entity
Organization
Contact information
Practice address
4217 W MEDLOCK DR, PHOENIX, AZ 85019-2427
(714) 858-2184
Mailing address
582 MANHATTAN WAY, CORONA, CA 92881-8400
(714) 858-1284
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH7820
AZDHS
AZ
Enumeration date
08/24/2022
Last updated
08/24/2022
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