Bougainvillea Manor LLC
NPI #1477396661 in Laveen, Arizona
Provider Information
- NPI Number
- 1477396661
- Entity Type
- Organization
- Organization Name
- Bougainvillea Manor LLC
- Primary Specialty
- Community Based Residential Treatment Facility, Mental Illness
- Enumeration Date
- Jun 14, 2024
- Last Updated
- Jul 12, 2024
Practice Location
Authorized Official
- Name
- MR. KRISHNA P ASHILI
- Title
- ADMINISTRATOR
- Phone
- (480) 239-9648
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community Based Residential Treatment Facility, Mental Illness |
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