Organization
KOMAKO HOUSE
Active
Organization
KOMAKO HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEAN SIAHA (DIRECTOR/PROVIDER)
(520) 272-7911
Entity
Organization
Contact information
Practice address
3560 W FENTON WAY, TUCSON, AZ 85746-2550
(520) 272-7911
Mailing address
3560 W FENTON WAY, TUCSON, AZ 85746-2550
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
BH3831
AZ
Other
Enumeration date
03/15/2011
Last updated
03/15/2011
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