Individual
LUBUNGA MWIMBILWA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2805 W TUCKEY LN, PHOENIX, AZ 85017-1240
(480) 297-1358
Mailing address
2805 W TUCKEY LN, PHOENIX, AZ 85017-1240
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
BH6098
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH6098
AZ DEPT OF HEALTH SERVICES
AZ
Enumeration date
05/11/2020
Last updated
05/11/2020
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