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General NPI Number Information
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NPI Number | 1821788399
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Entity Type | Organization
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Legal Business Name | THE FAMILY HOUSE BEHAVIORAL SERVICES LLC
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Dates
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Enumeration Date | 05/09/2023
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Last Update Date | 05/09/2023
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Provider Practice Location Address
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Address Line | 1323 S 173RD LN
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City | GOODYEAR
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State | AZ
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Zip | 85338-1949
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Country | US
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Telephone | 207-482-9832
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Fax |
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Provider Business Mailing Address
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Address Line | 5518 W CARSON RD
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City | LAVEEN
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State | AZ
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Zip | 85339-2270
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Country | US
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Telephone | 207-482-9832
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | VICTOR MUGABO
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Credential |
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Telephone | 207-482-9832
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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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