Organization
BONDING WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MUTONI MASENGESHO (ADMINISTRATOR)
(832) 206-3708
Entity
Organization
Contact information
Practice address
3420 E SHEA BLVD, PHOENIX, AZ 85028-3345
(832) 206-3708
Mailing address
3420 E SHEA BLVD, PHOENIX, AZ 85028-3345
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
08/09/2023
Last updated
08/09/2023
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