Organization
MUCO BEHAVIORAL HEALTH RESIDENTIAL HOME 2
Active
Parent organization
MUCO BEHAVIORAL HEALTH RESIDENTIAL HOME, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MUCO BEHAVIORAL HEALTH RESIDENTIAL HOME, LLC
Authorized official
MR. DEOGRATIAS BARANSAKA (ADMINISTRATOR)
(623) 760-8378
Entity
Organization
Contact information
Practice address
9010 N 63RD DR, GLENDALE, AZ 85302-4031
(623) 328-5688
(623) 328-5688
Mailing address
9010 N 63RD DR, GLENDALE, AZ 85302-4031
(623) 328-5688
(623) 328-5688
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
BH5344
AZ
Other
Enumeration date
01/22/2018
Last updated
01/22/2018
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