Organization
BENCHMARK VALLEY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TITUS KIMANI MWANGI (ADMINISTRATOR)
(858) 386-6705
Entity
Organization
Contact information
Practice address
3230 W JESSICA LN, PHOENIX, AZ 85041-4345
(858) 386-6705
(602) 368-4535
Mailing address
5625 W EUCLID AVE, LAVEEN, AZ 85339-5247
(858) 386-6705
(602) 368-4535
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/13/2019
Last updated
07/02/2020
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