NPIMap

Organization Active NPI

Mwangaza Residential Care LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Tucson, AZ
National Provider Identifier
1841525151
Registry record updated Oct 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
BH-3425 Issued in AZ
Legal business name
MWANGAZA RESIDENTIAL CARE LLC
Practice address
2234 E Calle Sierra del Manantial
Tucson, AZ 85706-5052
Phone
(520) 207-9283
Fax
(520) 207-9283
NPI assigned
Oct 5, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2009

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

Authorized official

Name
Mr. Jonah Kibitok Maiyo, 04/05/1979
Title
Ceo/Program Director
Phone
(520) 248-1295

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X BH-3425 AZ Primary

Addresses

Primary practice location

2234 E Calle Sierra del Manantial
Tucson, AZ 85706-5052

Mailing address

2234 E Calle Sierra del Manantial
Tucson, AZ 85706-5052
Phone (520) 207-9283

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.

NPI Registry JSON

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

{
    "created_epoch": "1254700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254700800000",
    "number": "1841525151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2234 E CALLE SIERRA DEL MANANTIAL",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857065052",
            "telephone_number": "520-207-9283",
            "fax_number": "520-207-9283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2234 E CALLE SIERRA DEL MANANTIAL",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857065052",
            "telephone_number": "520-207-9283",
            "fax_number": "520-207-9283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MWANGAZA RESIDENTIAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-05",
        "last_updated": "2009-10-05",
        "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": "04/05/1979"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "AZ",
            "license": "BH-3425",
            "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 5, 2009; 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.