Organization
SAPPHIRE GROUP HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPHINE MUSYOKI (CEO)
(702) 945-8268
Entity
Organization
Contact information
Practice address
5227 W ALTA MESA AVE, LAVEEN, AZ 85339-5418
(702) 945-8268
Mailing address
5227 W ALTA MESA AVE, LAVEEN, AZ 85339-5418
(702) 945-8268
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
—
BH7044
AZDHS
AZ
Enumeration date
10/05/2021
Last updated
10/05/2021
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