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General NPI Number Information
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NPI Number | 1295670875
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Entity Type | Organization
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Legal Business Name | SKYBRIDGE HARMONY HOMES
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Dates
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Enumeration Date | 04/21/2026
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Last Update Date | 04/21/2026
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Provider Practice Location Address
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Address Line | 5848 S HASSETT
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City | MESA
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State | AZ
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Zip | 85212-5494
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Country | US
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Telephone | 480-207-1652
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Fax |
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Provider Business Mailing Address
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Address Line | 2993 S JEFFRY ST
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City | GILBERT
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State | AZ
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Zip | 85295-0047
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | TUMACHA AGHENEZA
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Credential |
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Telephone | 857-237-1713
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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