Organization · Type 2 NPI

Azi House LLC

Intellectual and/or Developmental Disabilities Residential Treatment Facility · Tucson, AZ

NPI number 1629305495 Active

Practice location

6914 S Bittercress Rd
Tucson, AZ 85756

Call (240) 643-0815 Map

Mailing address

5986 S Jakemp Trl
Tucson, AZ 85747-6003

Specialties and licenses

Taxonomy	Code	License
Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary	320600000X	None listed

Intellectual and/or Developmental Disabilities Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.

3 other providers at this address

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NPI record

NPI: 1629305495
Entity type: Organization (Type 2)
Issued: Nov 15, 2009
Last updated: Dec 27, 2019
Status: Active

Other names

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Azi House One · doing business as
Azi House One · doing business as

Authorized official

Mr. Michael Atabongnkeng Fuangunyi
Statutory Agent
(240) 643-0815

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1629305495

Azi House LLC's National Provider Identifier is 1629305495, issued on Nov 15, 2009. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Residential Treatment Facility (320600000X), and the practice location is in Tucson, AZ. The record was last updated on Dec 27, 2019.