Organization
BASAMI HOUSE,LLC
Active
Other names
BASAMI HOUSE LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JOYCE ODONGO CEO (ADMINISTRATOR)
(602) 903-9193
Entity
Organization
Contact information
Practice address
125 W VILLA RITA DR, PHOENIX, AZ 85023-6450
(602) 903-9193
(623) 322-9790
Mailing address
PO BOX 42927, PHOENIX, AZ 85080-2927
(602) 903-9193
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/26/2019
Last updated
08/26/2019
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