Life Anchor

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

LIFE ANCHOR

Practice address

17427 W Mission LN
Waddell, AZ 85355-4168

Phone

(405) 738-8130

NPI assigned

Aug 31, 2026

Last updated

Sep 21, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rene Moise Kwibuka

Title

Ceo

Phone

(405) 578-5031

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1788134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789948800000",
    "number": "1558279737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17427 W MISSION LN",
            "city": "WADDELL",
            "state": "AZ",
            "postal_code": "853554168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17427 W MISSION LN",
            "city": "WADDELL",
            "state": "AZ",
            "postal_code": "853554168",
            "telephone_number": "405-738-8130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE ANCHOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-31",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "status": "A",
        "authorized_official_last_name": "KWIBUKA",
        "authorized_official_first_name": "RENE MOISE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "405-578-5031"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2026; 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.