Tassiliman House LLC

NPI #1902613888 in Laveen, Arizona

Provider Information

NPI Number: 1902613888
Entity Type: Organization
Organization Name: Tassiliman House LLC
Primary Specialty: Community Based Residential Treatment Facility, Mental Illness
Enumeration Date: Dec 14, 2024
Last Updated: Dec 17, 2024

Practice Location

Address: 7419 W DARROW ST
City: Laveen
State: Arizona
ZIP Code: 85339-2644
Phone: (623) 248-9448

Authorized Official

Name: MOHAMED KALLE
Title: ADMINISTRATOR
Phone: (602) 884-3162

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Mental Illness	320800000X	Primary

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