Provider Demographics
NPI:1508454620
Name:SANGA HEALTHCARE, LLC
Entity Type:Organization
Organization Name:SANGA HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MUSA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANGARIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-338-9764
Mailing Address - Street 1:PO BOX 39025
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85069-9025
Mailing Address - Country:US
Mailing Address - Phone:480-338-9764
Mailing Address - Fax:
Practice Address - Street 1:7102 N 35TH AVE STE 4
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85051-8390
Practice Address - Country:US
Practice Address - Phone:480-338-9764
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-05
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children