Organization
COLL COMMUNITY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLLINS KUKWA AYEAH (ADMINISTRATOR)
(954) 544-9065
Entity
Organization
Contact information
Practice address
4545 N 67TH AVE UNIT 1109, PHOENIX, AZ 85033-1670
(954) 544-9065
Mailing address
4545 N 67TH AVE UNIT 1109, PHOENIX, AZ 85033-1670
(954) 544-9065
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/18/2020
Last updated
10/02/2024
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