Hawk House LLC
Community Based Residential Treatment Facility, Mental Illness in Surprise, AZ. Organization (NPI-2).
NPI number1851988414
StatusActive
Last updated in NPPESDec 29, 2020
Details
- NPI
- 1851988414
- Entity type
- Organization (NPI-2)
- Legal business name
- Hawk House LLC
- Organization subpart
- No
- Enumeration date
- Dec 29, 2020
- Certification date
- Dec 29, 2020
- Last updated
- Dec 29, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320800000X | Community Based Residential Treatment Facility, Mental Illness | – | – | Yes |
Practice location
15227 W Country Gables DrSurprise, AZ 85379-7025
Phone 715-202-3461 · Fax 602-806-6203
Mailing address
15227 W Country Gables DrSurprise, AZ 85379-7025
Phone 715-202-3461 · Fax 602-806-6203
Authorized official
Mataele Kaveinga
Ceo
7152023461
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