Organization
MBABAZI HOMES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LORRIS MICHAEL MBABAZI (OWNER)
(320) 266-7514
Entity
Organization
Contact information
Practice address
7010 S 19TH LN, PHOENIX, AZ 85041-6654
(320) 266-7514
Mailing address
7010 S 19TH LN, PHOENIX, AZ 85041-6654
(320) 266-7514
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/15/2021
Last updated
03/15/2021
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