Tassiliman House LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

TASSILIMAN HOUSE LLC

Practice address

7419 W Darrow St
Laveen, AZ 85339-2644

Phone

(623) 248-9448

NPI assigned

Dec 14, 2024

Organization subpart

No

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

Authorized official

Name

Mohamed Kalle

Title

Administrator

Phone

(602) 884-3162

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1734134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734393600000",
    "number": "1902613888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 N 112TH DR",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853237902",
            "telephone_number": "623-248-9448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7419 W DARROW ST",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853392644",
            "telephone_number": "623-248-9448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TASSILIMAN HOUSE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-14",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A",
        "authorized_official_last_name": "KALLE",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "602-884-3162"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Illness Community Based Residential Treatment Facility in Laveen, AZ
• Providers in Laveen, AZ by specialty
• Mental Illness Community Based Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; 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.