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NPI Code Detail

MEDICARE: MARIE KALUNGI

MEDICARE: MARIE KALUNGI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1320800000XMental Illness Community Based Residential Treatment Facility

General Provider Information

NPI Number : 1689386401
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIE KALUNGI
Provider Business Mailing Address
First Line : 5526 W WALATOWA ST
Second Line :
City : LAVEEN
State : AZ
Zip : 85339-5497
Country : US
Telephone Number : 702-521-7745
Fax Number :
Provider Business Practice Location Address
First Line : 2775 W PEBBLE RD UNIT 501
Second Line :
City : LAS VEGAS
State : NV
Zip : 89123-6564
Country : US
Telephone Number : 702-521-7745
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2022
Last Update Date : 12/23/2022

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Directions to “ MARIE KALUNGI ” Practice Location

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