Organization
LASAFE HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LUCY ACHAN (EXECUTIVE DIRECTOR)
(469) 900-9766
Entity
Organization
Contact information
Practice address
3306 W WALNUT ST STE 403, GARLAND, TX 75042-7115
(469) 900-9766
(469) 519-0207
Mailing address
3306 W WALNUT ST STE 403, GARLAND, TX 75042-7115
(469) 900-9766
(469) 519-0207
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/08/2021
Last updated
10/08/2021
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