institution
Ebenezer House I , Llc
Intellectual and/or Developmental Disabilities Residential Treatment Facility in Phoenix, Arizona
NPI 1407426273

Ebenezer House I , Llc is a Intellectual and/or Developmental Disabilities Residential Treatment Facility based in Phoenix, AZ. Ebenezer House I , Llc practices in Phoenix, AZ. The NPI Number for Ebenezer House I , Llc is 1407426273 and holds a License No. (Arizona).

The current practice location address for Ebenezer House I , Llc is 4055 N 77Th Dr, Phoenix, AZ and can be reached out via phone at 623-440-4404 and via fax at 623-777-0082.

Location: 4055 N 77Th Dr, Phoenix, AZ, 85037-1269
institution
Provider Profile Details
NPI Number
1407426273
Provider Name
Ebenezer House I , Llc
Credential
Provider Entity Type
Organization
Address
4055 N 77Th Dr, Phoenix, AZ, 85037-1269
Phone Number
623-440-4404
Fax Number
623-777-0082
Provider Enumeration Date
06/24/2021
Last Update Date
03/10/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
0000 05 AZ
institution
Provider Business Practice Location Address Details
Address
4055 N 77Th Dr
City
State
Zip
85033-3618
Phone Number
623-440-4404
Fax Number
623-777-0082
person
Provider Business Mailing Address Details
Address
4055 N 77Th Dr
City
State
Zip
85033-3618
Phone Number
623-440-4404
Fax Number
623-777-0082
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
License No.
()
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
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