Provider Demographics
NPI:1740066976
Name:LUX SPEI HOMES LLC, DBA
Entity type:Organization
Organization Name:LUX SPEI HOMES LLC, DBA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EDMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:NYAGATARE MANZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-394-5954
Mailing Address - Street 1:2906 W HUNTINGTON DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85041-4450
Mailing Address - Country:US
Mailing Address - Phone:602-394-5954
Mailing Address - Fax:
Practice Address - Street 1:2906 W HUNTINGTON DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85041-4450
Practice Address - Country:US
Practice Address - Phone:602-394-5954
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-04
Last Update Date:2023-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness