Organization
FJCM BEHAVIORAL HEALTH CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAUSTIN BULONGO KAPELEMBA (CO-OWNER)
(602) 643-5723
Entity
Organization
Contact information
Practice address
2710 E VALENCIA DR, PHOENIX, AZ 85042-7081
(602) 643-5723
(602) 281-6742
Mailing address
4730 W SAMANTHA WAY, LAVEEN, AZ 85339-2141
(602) 643-5723
(602) 281-6742
Taxonomy
Speciality
Code
Description
License number
State
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
12/28/2018
Last updated
12/28/2018
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