Provider Demographics
NPI:1013375518
Name:DALASI'S HOUSE LLC
Entity Type:Organization
Organization Name:DALASI'S HOUSE LLC
Other - Org Name:DALASI'S HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DALASI
Authorized Official - Middle Name:BUNCHIE
Authorized Official - Last Name:OWUSU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-835-5084
Mailing Address - Street 1:200 VALLEY WOOD DR STE A300
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3573
Mailing Address - Country:US
Mailing Address - Phone:210-763-7149
Mailing Address - Fax:210-384-2581
Practice Address - Street 1:200 VALLEY WOOD DR STE A300
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-3573
Practice Address - Country:US
Practice Address - Phone:210-763-7149
Practice Address - Fax:210-384-2581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-29
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX017522253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1073037958Medicaid