NPI 1073812152

Komako House

Organisation Mental Illness Community Based Residential Treatment Facility Tucson, AZ

Practice location

Address: 3560 W Fenton Way, Tucson, AZ 85746-2550
Phone: (520) 272-7911

Authorised official

Name: Jean Siaha
Title: Director/Provider
Phone: (520) 272-7911

Registered specialties

Mental Illness Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320800000X Licence BH3831 (AZ)

Other Community Based Residential Treatment Facility, Mental Illness providers in Arizona →

Registry record

NPI: 1073812152
Entity type: Organization
NPI issued: 15 Mar 2011
Record last updated: 15 Mar 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.