IndividualActive
Bahati Bakanga
NPI 1124823794 · Mental Illness Community Based Residential Treatment Facility · Buckeye, AZ
Provider details
- NPI number
- 1124823794
- Entity type
- Individual
- Primary specialty
- Mental Illness Community Based Residential Treatment FacilityResidential Treatment Facilities
- Sex
- Male
- Sole proprietor
- Yes
- License
- BH10421 (AZ)
Specialties & taxonomies
Residential Treatment Facilities
Respite Care Facility
Practice location
23835 W Hidalgo Ave
Buckeye, AZ 85326-7008
Phone: (702) 465-7946
Approximate (ZIP-level) locationGet directions
Mailing address
4000 N Central Ave Ste 100
Phoenix, AZ 85012-3520
Registry dates
- Enumerated
- 2025-02-17
- Last updated
- 2025-02-17
- Certified
- 2025-02-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.