| Bansa House Llc | |
|
7225 E Stella Rd Tucson AZ 85730-2336 | |
| (520) 891-0513 | |
| Not Available |
| Full Name | Bansa House Llc |
|---|---|
| Speciality | Residential Treatment Facility, Intellectual And/or Developmental Disabilities |
| Location | 7225 E Stella Rd, Tucson, Arizona |
| Authorized Official Name and Position | Agendia Taku (MEMBER) |
| Authorized Official Contact | 5203889814 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bansa House Llc 6788 S Sonoran Bloom Ave Tucson AZ 85756-3040 Ph: (520) 891-0513 | Bansa House Llc 7225 E Stella Rd Tucson AZ 85730-2336 Ph: (520) 891-0513 |
| NPI Number | 1144796681 |
|---|---|
| Provider Enumeration Date | 10/23/2018 |
| Last Update Date | 01/08/2021 |
| Certification Date | 01/08/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144796681 | NPI | - | NPPES |
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