Organization
MUCO BEHAVIORAL HEALTH RESIDENTIAL HOME, LLC
Active
Other names
Muco Home 3
Organization subpart
No
Provider details
NPI number
Authorized official
DEOGRATIAS BARANSAKA MA (ADMINISTRATOR)
(623) 760-8378
Entity
Organization
Contact information
Practice address
12413 W MONROE ST, AVONDALE, AZ 85323-8002
(623) 600-8283
Mailing address
12413 W MONROE ST, AVONDALE, AZ 85323-8002
(623) 600-8384
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/31/2023
Last updated
10/16/2024
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