Organization
WERISE BEHAVIORAL HOME LLC
Active
Other names
Werise Behavioral Home LLC, Werise
Organization subpart
No
Provider details
NPI number
Authorized official
IBRAHIM MOHAMUD HASSAN (AGENT)
(480) 324-6692
Entity
Organization
Contact information
Practice address
10514 W HILTON AVE, TOLLESON, AZ 85353-5615
(612) 987-4404
Mailing address
1652 N 52ND ST APT 13, PHOENIX, AZ 85008-3419
(480) 324-6692
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
251V00000X
Voluntary or Charitable Agency
—
—
Other
Enumeration date
06/21/2022
Last updated
06/21/2022
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