Provider Demographics
NPI:1063106136
Name:STAUNCH TRANSITIONAL HOMES LLC
Entity type:Organization
Organization Name:STAUNCH TRANSITIONAL HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:HANIFAH
Authorized Official - Middle Name:
Authorized Official - Last Name:NABAKOOZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-853-1365
Mailing Address - Street 1:6209 S 43RD DR
Mailing Address - Street 2:
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339-6297
Mailing Address - Country:US
Mailing Address - Phone:818-853-1365
Mailing Address - Fax:
Practice Address - Street 1:6209 S 43RD DR
Practice Address - Street 2:
Practice Address - City:LAVEEN
Practice Address - State:AZ
Practice Address - Zip Code:85339-6297
Practice Address - Country:US
Practice Address - Phone:818-853-1365
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances