# BANSA ENTERPRISES INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598367120
- **Authorized official:** PRUDENTIA TAKU (OWNER)
- **Authorized official phone:** (520) 440-1412

## Contact information

- **Practice address:** 6788 S SONORAN BLOOM AVE, TUCSON, AZ 85756-3040
- **Practice address phone:** (520) 440-1412
- **Mailing address:** 6788 S SONORAN BLOOM AVE, TUCSON, AZ 85756-3040
- **Mailing address phone:** (520) 440-1412

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103K00000X | Behavior Analyst | — | NULL | — |
| 103K00000X | Behavior Analyst | — | — | — |
| 251E00000X | Home Health Agency | — | NULL | Yes |
| 310400000X | Assisted Living Facility | — | NULL | — |
| 3104A0630X | Assisted Living Facility (Behavioral Disturbances) | — | NULL | — |
| 320800000X | Mental Illness Community Based Residential Treatment Facility | — | NULL | — |

## Other

- **Enumeration date:** 11/09/2020
- **Last updated:** 01/09/2021