| Huduma House, Llc | |
|
6249 W Southgate St Phoenix AZ 85043-1909 | |
| (602) 296-4013 | |
| (602) 932-1390 |
| Full Name | Huduma House, Llc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 6249 W Southgate St, Phoenix, Arizona |
| Authorized Official Name and Position | Robert Koskei (CEO) |
| Authorized Official Contact | 6025169785 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Huduma House, Llc 6835 S Willow Dr Tempe AZ 85283-4137 Ph: (602) 516-9785 | Huduma House, Llc 6249 W Southgate St Phoenix AZ 85043-1909 Ph: (602) 296-4013 |
| NPI Number | 1184334641 |
|---|---|
| Provider Enumeration Date | 11/24/2022 |
| Last Update Date | 11/24/2022 |
| Certification Date | 11/24/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184334641 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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