Organization
GATEKA HOUSE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN PAUL MBONINYERESTE (ADMINISTRATOR)
(602) 358-3396
Entity
Organization
Contact information
Practice address
9415 W PALM LN, PHOENIX, AZ 85037-4414
(602) 358-3396
Mailing address
9415 W PALM LN, PHOENIX, AZ 85037-4414
(602) 358-3396
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/06/2024
Last updated
05/06/2024
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