Werise Behavioral Home LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

WERISE BEHAVIORAL HOME LLC

Practice address

10514 W Hilton Ave
Tolleson, AZ 85353-5615

Phone

(612) 987-4404

NPI assigned

Jun 21, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ibrahim Mohamud Hassan

Title

Agent

Phone

(480) 324-6692

Specialties & licenses 2

Addresses

Other names 2

• Werise Doing business as
• Werise Behavioral Home LLC Former legal business name

Electronic endpoints 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1655769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655769600000",
    "number": "1134850050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1652 N 52ND ST APT 13",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850083419",
            "telephone_number": "480-324-6692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10514 W HILTON AVE",
            "city": "TOLLESON",
            "state": "AZ",
            "postal_code": "853535615",
            "telephone_number": "612-987-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WERISE BEHAVIORAL HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-21",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A",
        "authorized_official_last_name": "HASSAN",
        "authorized_official_first_name": "IBRAHIM",
        "authorized_official_middle_name": "MOHAMUD",
        "authorized_official_title_or_position": "AGENT",
        "authorized_official_telephone_number": "480-324-6692"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Werisehome@outlook.com",
            "affiliation": "N",
            "address_1": "10514 W Hilton Ave",
            "city": "Tolleson",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853535615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Werise",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Werise Behavioral Home LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Cynthia Walker, R.N.
• Babylonia Warda
• Derek Lee Warren, OD
• Erica S Washington
• Temesgen Wedajo
• Stephanie Jean Wernsman, PHARM.D.
• Wigslayers
• Amy Lauren Wilgus, BS
• Carlita Denette Williams
• Samantha Winfield

• Community/Behavioral Health Agency in Tolleson, AZ
• Providers in Tolleson, AZ by specialty
• Community/Behavioral Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.