Organization
BENEDICTA HOUSE
Active
Organization
BENEDICTA HOUSE
Active
Parent organization
SHALOM BEHAVIORAL HOUSE, LLC
Other names
BENEDICTA HOUSE
Organization subpart
Yes
Provider details
NPI number
Legal business name
SHALOM BEHAVIORAL HOUSE, LLC
Authorized official
AIME MUKURA LINDA MINEGA SHABANI BHT (ADMINISTRATOR)
(602) 477-9416
Entity
Organization
Contact information
Practice address
3349 E CAMBRIDGE AVE, PHOENIX, AZ 85008-1215
(602) 477-9416
Mailing address
11063 W VIRGINIA AVE, AVONDALE, AZ 85392-5889
(602) 477-9416
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/01/2024
Last updated
02/01/2024
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