Provider Demographics
NPI:1023770906
Name:LASAFE HOME LLC
Entity type:Organization
Organization Name:LASAFE HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LUCY
Authorized Official - Middle Name:
Authorized Official - Last Name:ACHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-900-9766
Mailing Address - Street 1:3306 W WALNUT ST STE 403
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-7115
Mailing Address - Country:US
Mailing Address - Phone:469-900-9766
Mailing Address - Fax:469-519-0207
Practice Address - Street 1:3306 W WALNUT ST STE 403
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-7115
Practice Address - Country:US
Practice Address - Phone:469-900-9766
Practice Address - Fax:469-519-0207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-08
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251B00000XAgenciesCase Management
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness