NPIMap

Organization Active NPI

Mwangaza Residential Care LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Tucson, AZ
National Provider Identifier
1528330339
Registry record updated Oct 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
MWANGAZA RESIDENTIAL CARE LLC
Practice address
6330 S Kolb Rd
Tucson, AZ 85756-9287
Phone
(520) 248-1295
Fax
(520) 338-2490
NPI assigned
Feb 8, 2012
Last updated
Oct 9, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Jonah Kibitok Maiyo, CEO/PROGRAM DIRECTOR
Title
Ceo/Program Director
Phone
(520) 248-1295

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X NU Primary

Addresses

Primary practice location

6330 S Kolb Rd
Tucson, AZ 85756-9287

Mailing address

8618 N Western Juniper Ter
Tucson, AZ 85743-7132
Phone (520) 248-1295

National Provider Directory

National Provider Directory
Tax ID family
Mwangaza Residential Care LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6330 S Kolb Rd
Tucson, AZ 85756
Phone (520) 248-1295

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1328659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539043200000",
    "number": "1528330339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8618 N WESTERN JUNIPER TER",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857437132",
            "telephone_number": "520-248-1295",
            "fax_number": "520-338-2490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6330 S KOLB RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857569287",
            "telephone_number": "520-248-1295",
            "fax_number": "520-338-2490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MWANGAZA RESIDENTIAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-08",
        "last_updated": "2018-10-09",
        "status": "A",
        "authorized_official_last_name": "MAIYO",
        "authorized_official_first_name": "JONAH",
        "authorized_official_middle_name": "KIBITOK",
        "authorized_official_title_or_position": "CEO/PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "520-248-1295",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CEO/PROGRAM DIRECTOR"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.