EBONY HOUSE INC (NPI# 1023170933) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023170933 |
| Entity Type | Organization |
| Organization Name | EBONY HOUSE INC |
| Practice Address |
6218 S 13th St Phoenix AZ 85042-4408 |
| Mailing Address |
6222 S 13th St Phoenix AZ 85042-4408 |
| Practice Telephone | 6022764288 |
| Practice Fax Number | 6022322938 |
| Mailing Telephone | 6022764288 |
| Mailing Fax Number | 6022322938 |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | WILLIAM FREEMAN (CEO) |
| Authorized Official Telephone | 6022764288 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | BH076 | AZ | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | AHCCCS NUMBER | 319790 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144790460 | Ebony House Inc | Substance Abuse Rehabilitation Facility | 6222 S. 13th Street, Phoenix, AZ 85042 | 2018-11-29 |
| 1568937407 | Ebony House Inc | Clinic/Center | 1616 E Indian School Rd Ste 250, Phoenix, AZ 85016-8614 | 2018-10-08 |
| 1710161419 | Ebony House Inc | Counselor | 6222 S 13th St, Phoenix, AZ 85042-4408 | 2007-12-18 |
| 1851455604 | Ebony House Inc | Substance Abuse Rehabilitation Facility | 8646 S 14th St, Phoenix, AZ 85042-7902 | 2006-12-19 |
| 1518029453 | Ebony House Inc | Case Management | 1616 E Indian School Rd, Suite 100, Phoenix, AZ 85016-8601 | 2006-12-15 |
| 1063073203 | Ebony House Inc | Clinic/Center | 1616 E Indian School Rd Ste 415, Phoenix, AZ 85016-8604 | 2019-06-27 |
| 1114171527 | Ebony House Inc | Substance Abuse Rehabilitation Facility | 6222 S 13th St, Phoenix, AZ 85042-4408 | 2008-11-12 |
| Street Address |
6218 S 13TH ST |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85042-4408 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306443197 | Da Homes LLC | Case Management | 8026 S. 24th Way, Phoenix, AZ 85042 | 2020-10-05 |
| 1144790460 | Ebony House Inc | Substance Abuse Rehabilitation Facility | 6222 S. 13th Street, Phoenix, AZ 85042 | 2018-11-29 |
| 1427538362 | Abigail Mcgrath | Dietitian, Registered | 303 E Baseline Rd Ste 200, Phoenix, AZ 85042 | 2018-08-20 |
| 1174028310 | Olufemi A Omodara | Pharmacist | 7227 S. Central Ave, #1080, Phoenix, AZ 85042 | 2018-03-29 |
| 1720537699 | Mary Youngblood | Registered Nurse | 7210 S 27th Way, Phoenix, AZ 85042 | 2016-10-03 |
| 1922490382 | Brian Zembower | Optometrist | 610 E Baseline Rd Ste C3, Phoenix, AZ 85042 | 2015-02-23 |
| 1417299819 | Robert Murphy Portley | Psychiatry & Neurology | 2320 E Baseline Rd Ste 148-225, Phoenix, AZ 85042 | 2013-03-23 |
| 1972807998 | Obinna Chukwuka Akubukwe | Pharmacist | 6006 S. Central Avenue, Phoenix, AZ 85042 | 2011-01-05 |
| 1104120328 | Gisheys Patient Care LLC | Custodial Care Facility | 7232 South 12th Place, Phoeniz, AZ 85042 | 2011-01-03 |
| 1245463488 | Lois Ann Hammitt | Registered Nurse | 6218 S. 7th Street, Phoenix, AZ 85042 | 2009-09-03 |
| Find all providers in zip 85042 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932726361 | Northstar Homecare LLC | Substance Abuse Rehabilitation Facility | 5239 S 33rd Dr, Phoenix, AZ 85041-7411 | 2020-07-01 |
| 1891312542 | Semper Fidelis Behavioral Health Care, LLC | Substance Abuse Rehabilitation Facility | 8020 N 17th Dr, Phoenix, AZ 85021-5217 | 2020-06-29 |
| 1558988246 | Cmj Recovery Az LLC | Substance Abuse Rehabilitation Facility | 4122 N 17th St Bldg A, Phoenix, AZ 85016-5922 | 2020-06-29 |
| 1720549009 | Rtc Management Group, LLC | Substance Abuse Rehabilitation Facility | 1340 E Desert Cove Ave, Phoenix, AZ 85020-1110 | 2019-03-28 |
| 1497227771 | Vogue Recovery Center Outpatient | Substance Abuse Rehabilitation Facility | 4122 N 17th St Bldg C, Phoenix, AZ 85016-5922 | 2018-12-26 |
| 1780155077 | Pb Medical Group of Arizona, LLC | Substance Abuse Rehabilitation Facility | 3000 N 91st Ave, Phoenix, AZ 85037-4037 | 2018-12-11 |
| 1144790460 | Ebony House Inc | Substance Abuse Rehabilitation Facility | 6222 S. 13th Street, Phoenix, AZ 85042 | 2018-11-29 |
| 1891283149 | Bbc Whitton, LLC | Substance Abuse Rehabilitation Facility | 1106 E Whitton Ave, Phoenix, AZ 85014-5053 | 2018-04-23 |
| 1417456336 | Vogue Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 4122 N 17th St, Phoenix, AZ 85016-5922 | 2018-02-06 |
| 1992254338 | A Path of Resilience | Substance Abuse Rehabilitation Facility | 6102 S 37th Ln, Phoenix, AZ 85041-5021 | 2016-09-27 |
| Find all providers in PHOENIX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.