Organization
SHANTI HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEPSIBAH ANJURI (OWNER/PROVIDER)
(520) 296-9139
Entity
Organization
Contact information
Practice address
7420 E LAKESIDE DR, TUCSON, AZ 85730-3321
(520) 296-9139
Mailing address
7420 E LAKESIDE DR, TUCSON, AZ 85730-3321
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
BH-4445
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
575563
—
AZ
Enumeration date
12/01/2010
Last updated
02/21/2014
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