Organization
MWANGAZA RESIDENTIAL CARE LLC
Active
Organization
MWANGAZA RESIDENTIAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONAH KIBITOK MAIYO (CEO/PROPGRAM DIRECTOR)
(520) 248-1295
Entity
Organization
Contact information
Practice address
2226 N AVENIDA EL CAPITAN, TUCSON, AZ 85705-5741
(520) 396-4074
(520) 499-3122
Mailing address
8618 N WESTERN JUNIPER TER, TUCSON, AZ 85743-7132
(520) 248-1295
(520) 338-2490
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
BH-4730
AZ
Other
Enumeration date
10/04/2015
Last updated
10/04/2015
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