Organization
KISMA HOME CARE LLC
Active
Organization
KISMA HOME CARE LLC
Active
Other names
BEHAVIORAL HEALTH RESIDENTIAL FACILITY
Organization subpart
No
Provider details
NPI number
Authorized official
MATHENGE SANGARIE (OWNER)
(480) 686-5901
Entity
Organization
Contact information
Practice address
11202 W PIERCE ST, AVONDALE, AZ 85323-7917
(480) 686-5901
Mailing address
11202 W PIERCE ST, AVONDALE, AZ 85323-7917
(480) 686-5901
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
—
—
Other
Enumeration date
05/27/2024
Last updated
01/07/2025
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