| Muco Behavioral Health Residential Home 2 | |
|
9010 N 63rd Dr Glendale AZ 85302-4031 | |
| (623) 328-5688 | |
| (623) 328-5688 |
| Full Name | Muco Behavioral Health Residential Home 2 |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 9010 N 63rd Dr, Glendale, Arizona |
| Authorized Official Name and Position | Deogratias Baransaka (ADMINISTRATOR) |
| Authorized Official Contact | 6237608378 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Muco Behavioral Health Residential Home 2 9010 N 63rd Dr Glendale AZ 85302-4031 Ph: (623) 328-5688 | Muco Behavioral Health Residential Home 2 9010 N 63rd Dr Glendale AZ 85302-4031 Ph: (623) 328-5688 |
| NPI Number | 1396253514 |
|---|---|
| Provider Enumeration Date | 01/22/2018 |
| Last Update Date | 01/22/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396253514 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | BH5344 (Arizona) | Primary |
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