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Organization

NEW MERVEILLE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DESIRE NKOMEZI (OWNER)
(817) 707-2798
Entity
Organization

Contact information

Practice address
2375 E CAMELBACK RD STE 600, PHOENIX, AZ 85016-3493
(817) 707-2798
Mailing address
4821 N 108TH AVE, PHOENIX, AZ 85037-5471
(817) 707-2798

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
261QM0850X
Adult Mental Health Clinic/Center
324500000X
Substance Abuse Rehabilitation Facility

Other

Enumeration date
01/29/2024
Last updated
03/21/2025
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