Provider Demographics
NPI:1538939038
Name:REAL SOLUTIONS TREATMENT CENTER INC
Entity type:Organization
Organization Name:REAL SOLUTIONS TREATMENT CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PASCAL
Authorized Official - Middle Name:N
Authorized Official - Last Name:MUNYUNDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-249-9758
Mailing Address - Street 1:4136 N 75TH AVE STE 211
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85033-3169
Mailing Address - Country:US
Mailing Address - Phone:208-249-9758
Mailing Address - Fax:
Practice Address - Street 1:4136 N 75TH AVE STE 211
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85033-3169
Practice Address - Country:US
Practice Address - Phone:208-249-9758
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-05
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)