# BANSA HOUSE LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** BANSA ENTERPRISES INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1144796681
- **Legal business name:** BANSA ENTERPRISES INC
- **Authorized official:** AGENDIA TAKU (MEMBER)
- **Authorized official phone:** (520) 388-9814

## Contact information

- **Practice address:** 7225 E STELLA RD, TUCSON, AZ 85730-2336
- **Practice address phone:** (520) 891-0513
- **Mailing address:** 6788 S SONORAN BLOOM AVE, TUCSON, AZ 85756-3040
- **Mailing address phone:** (520) 891-0513

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 3104A0630X | Assisted Living Facility (Behavioral Disturbances) | — | NULL | — |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 10/23/2018
- **Last updated:** 01/08/2021