Organization
FAITH GROUP ANGELS, LLC
Active
Other names
Faith Group Angels
Organization subpart
No
Provider details
NPI number
Authorized official
UREJO HASSAN HAJI BARE (OWNER)
(623) 218-8074
Entity
Organization
Contact information
Practice address
5308 W NOVAK WAY, LAVEEN, AZ 85339
(623) 218-8074
Mailing address
5308 W NOVAK WAY, LAVEEN, AZ 85339
(623) 218-8074
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1922739663
BEHAVIORAL HEALTH RESIDENTIAL FACILITY OPERATOR
AZ
Enumeration date
07/06/2022
Last updated
07/06/2022
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