Ebenezer House 1llc
NPI #1740910348 in Queen Creek, Arizona
Provider Information
- NPI Number
- 1740910348
- Entity Type
- Organization
- Organization Name
- Ebenezer House 1llc
- Primary Specialty
- Community/Behavioral Health
- Enumeration Date
- Jun 15, 2022
- Last Updated
- Jun 15, 2022
Practice Location
- Address
- 35168 N MAGNETTE WAY
- City
- Queen Creek
- State
- Arizona
- ZIP Code
- 85142-3916
- Phone
- (407) 236-6552
Authorized Official
- Name
- OSSIE TORGRIMSON
- Title
- CHIEF OFFICER FINANICAL
- Phone
- (407) 236-6552
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community/Behavioral Health |
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