Individual provider · Type 1 NPI

Koffi Dzaka

Mental Illness Community Based Residential Treatment Facility · Tucson, AZ

NPI number 1326867987 Active

Practice location

6692 S Stone Fly Dr
Tucson, AZ 85757-1607

Call (520) 251-4186 Map

Mailing address

4000 N Central Ave Ste 100
Phoenix, AZ 85012-3520

Specialties and licenses

TaxonomyCodeLicense
Respite Care 385H00000XBH10286 (AZ)
Mental Illness Community Based Residential Treatment Facility Primary 320800000XBH10286 (AZ)

Mental Illness Community Based Residential Treatment Facility: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

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About NPI 1326867987

Koffi Dzaka's National Provider Identifier is 1326867987, issued on Oct 9, 2024. The primary taxonomy on file is Mental Illness Community Based Residential Treatment Facility (320800000X), and the practice location is in Tucson, AZ. The record was last updated on Dec 3, 2024.