| Dayton Hospitality Llc | |
|
6751 N Sunset Blvd Ste 320 Glendale AZ 85305-3155 | |
| (443) 610-1249 | |
| Not Available |
| Full Name | Dayton Hospitality Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 6751 N Sunset Blvd Ste 320, Glendale, Arizona |
| Authorized Official Name and Position | Joseph Nekambuza (OWNER) |
| Authorized Official Contact | 4436101249 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dayton Hospitality Llc 3293 S Wabash Ct Denver CO 80231-4523 Ph: (443) 610-1249 | Dayton Hospitality Llc 6751 N Sunset Blvd Ste 320 Glendale AZ 85305-3155 Ph: (443) 610-1249 |
| NPI Number | 1942906516 |
|---|---|
| Provider Enumeration Date | 02/06/2023 |
| Last Update Date | 04/15/2023 |
| Certification Date | 04/15/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942906516 | NPI | - | NPPES |
| 365162 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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