Organization
KINGDOM BEHAVIOR CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD NKUSI (OWNER)
(469) 455-4874
Entity
Organization
Contact information
Practice address
3048 E BASELINE RD STE 101, MESA, AZ 85204-7287
(469) 455-4874
Mailing address
3048 E BASELINE RD STE 101, MESA, AZ 85204-7287
(469) 455-4874
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/10/2023
Last updated
05/10/2023
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