Provider Demographics
NPI:1114612702
Name:GAKEI, KAYIJAMAHE
Entity Type:Individual
Prefix:
First Name:KAYIJAMAHE
Middle Name:
Last Name:GAKEI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 464
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85380-0464
Mailing Address - Country:US
Mailing Address - Phone:832-546-3216
Mailing Address - Fax:
Practice Address - Street 1:7170 W CAMINO SAN XAVIER BLDG C
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-0833
Practice Address - Country:US
Practice Address - Phone:800-936-3736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)