Organization
TESTIMONY BEHAVIORAL HEALTH RESIDENTIAL LLC
Active
Other names
Testimony Behavioral Health Residential LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MOJAMA FATOMA (CEO/OWNER)
(623) 383-3759
Entity
Organization
Contact information
Practice address
1110 E GLENN DR, PHOENIX, AZ 85020-5347
(623) 383-3759
Mailing address
11770 W DAVIS LN, AVONDALE, AZ 85323-7695
(623) 383-3759
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
05/20/2024
Last updated
05/20/2024
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