Ebenezer Family Home 2

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL12048 Issued in FL

Legal business name

EBENEZER FAMILY HOME 2

Practice address

1024 SW 11TH St
Miami, FL 33129-1817

Phone

(305) 857-9425

NPI assigned

Jan 10, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Erich Capestany

Title

Administrator

Phone

(786) 376-6767

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1326153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326153600000",
    "number": "1144590001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1024 SW 11TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331291817",
            "telephone_number": "305-857-9425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 SW 11TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331291817",
            "telephone_number": "305-857-9425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EBENEZER FAMILY HOME 2",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-10",
        "last_updated": "2012-01-10",
        "status": "A",
        "authorized_official_last_name": "CAPESTANY",
        "authorized_official_first_name": "ERICH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "786-376-6767",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL12048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Alyssa Eatz, MD
• Anette Luisa Ebanks
• Ebenezer Behavior Center LLC
• Ebenezer Case Management Services, Inc
• Ebenezer Counseling Services Inc
• Ebenezer Family Home III LLC
• Ebenezer Support Services Corp
• Ebenezer Transport Services Corp,
• Ariel Eber, MD
• Scott Twery Eber, MD

• Assisted Living Facility in Miami, FL
• Providers in Miami, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.