Organization Name: | PASTALINO MANOR LLC 2 |
NPI Number: | 1326432741 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PAUL MUNYAO KIVILA (ADMINISTRATOR) |
Mailing Address: | 1383 W Kesler Ln Chandler |
State: | AZ US |
Postal Code: | 852247289 |
Phone Number: | 4806345485 |
Fax Number: | 4806997288 |
NPI Enumeration Date: | 03/24/2015 |
NPI Last Update Date: | 03/24/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320800000X |
License Number: | BH 4431 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AZ |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment Facility, Mental Illness |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |