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Organization

SOFI HEALTH CLINIC

Active
Other names
Sofi Health Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
KASIBANTE ANDREW KAYIIRA LVN (CEO)
(661) 523-5398
Entity
Organization

Contact information

Practice address
1020 W SOUTHERN AVE STE 2, MESA, AZ 85210-4804
(661) 523-5398
Mailing address
1020 W SOUTHERN AVE STE 2, MESA, AZ 85210-4804
(661) 523-5398

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
261QR0405X
INTENSIVE OUTPATIENT PROGRAMS AND CLINICS
AZ
Enumeration date
09/11/2023
Last updated
08/27/2024
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