Organization
HUDUMA HOUSE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT K. KOSKEI (HEALTHCARE ADMINISTRATOR)
(602) 516-9785
Entity
Organization
Contact information
Practice address
6218 W RAYMOND ST, PHOENIX, AZ 85043
(602) 675-4861
Mailing address
6218 W RAYMOND ST, PHOENIX, AZ 85043
(602) 675-4861
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
—
—
Other
Enumeration date
07/15/2020
Last updated
07/15/2020
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