Organization
MWANGAZA RESIDENTIAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONAH KIBITOK MAIYO (CEO/PROGRAM DIRECTOR)
(520) 248-1295
Entity
Organization
Contact information
Practice address
8421 E. COLETTE ST, TUCSON, AZ 85710
(520) 398-5674
(520) 305-3837
Mailing address
8618 N. WESTERN JUNIPER TERACCE, TUCSON, AZ 85743
(520) 248-1295
(520) 338-2490
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
BH-4900
AZ
Other
Enumeration date
05/06/2016
Last updated
05/06/2016
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