NPIMap

Organization Active NPI

Mwangaza Residential Care LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Tucson, AZ
National Provider Identifier
1609246560
Registry record updated Oct 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
BH-4730 Issued in AZ
Legal business name
MWANGAZA RESIDENTIAL CARE LLC
Practice address
2226 N Avenida El Capitan
Tucson, AZ 85705-5741
Phone
(520) 396-4074
Fax
(520) 499-3122
NPI assigned
Oct 4, 2015
Last updated
Oct 4, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2015

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

Authorized official

Name
Mr. Jonah Kibitok Maiyo
Title
Ceo/Propgram Director
Phone
(520) 248-1295

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X BH-4730 AZ Primary

Addresses

Primary practice location

2226 N Avenida El Capitan
Tucson, AZ 85705-5741

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

2226 N Avenida El Capitan
Tucson, AZ 85705
Phone (520) 396-4074

NPI Registry JSON

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

{
    "created_epoch": "1443916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443916800000",
    "number": "1609246560",
    "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": "2226 N AVENIDA EL CAPITAN",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857055741",
            "telephone_number": "520-396-4074",
            "fax_number": "520-499-3122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MWANGAZA RESIDENTIAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-04",
        "last_updated": "2015-10-04",
        "status": "A",
        "authorized_official_last_name": "MAIYO",
        "authorized_official_first_name": "JONAH",
        "authorized_official_middle_name": "KIBITOK",
        "authorized_official_title_or_position": "CEO/PROPGRAM DIRECTOR",
        "authorized_official_telephone_number": "520-248-1295",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "AZ",
            "license": "BH-4730",
            "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 4, 2015; 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.