Organization
ASHU LINEAGE BEHAVIORAL HEALTH
Active
Other names
Ashu Lineage Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN ETU MUKOKO DCW (OWNER/PRESIDENT)
(480) 409-8245
Entity
Organization
Contact information
Practice address
9423 W VIRGINIA AVE, PHOENIX, AZ 85037-4316
(480) 409-8245
Mailing address
9423 W VIRGINIA AVE, PHOENIX, AZ 85037-4316
(480) 409-8245
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
04/01/2024
Last updated
04/01/2024
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