Individual
FASHINGOMA MUGISHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
905 27TH ST N, FARGO, ND 58102-3134
(602) 751-1571
Mailing address
22453 N VANDERVEEN WAY, MARICOPA, AZ 85138-5570
(602) 751-1571
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/03/2025
Last updated
06/03/2025
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