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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