| NPI | 1396508446 |
|---|---|
| Doing Business As | PRINCE MICAH HOUSE |
| Entity Type | Organization |
| Authorized Contact | AIME MUKURA LINDA MINEGA SHABANI Administrator 602-477-9416 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2024-02-01 |
| Last Update Date | 2024-02-01 |