Healthcare Provider Details

I. General information

NPI: 1235067125
Provider Name (Legal Business Name): ASSURANCE BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45127 W YUCCA LN
MARICOPA AZ
85139-4271
US

IV. Provider business mailing address

45127 W YUCCA LN
MARICOPA AZ
85139-4271
US

V. Phone/Fax

Practice location:
  • Phone: 781-869-0186
  • Fax:
Mailing address:
  • Phone: 781-869-0186
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SOLOMON A KYAMBADDE
Title or Position: ADMINISTRATOR
Credential: KYAMBADDE
Phone: 781-869-0186