Jezzob Behavioral Health, LLC

Primary specialty

Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X

Legal business name

JEZZOB BEHAVIORAL HEALTH, LLC

Doing business as

Jezzob Behavioral Health, LLC

Practice address

7409 W Southgate Ave
Phoenix, AZ 85043-2058

Phone

(602) 521-2351

Fax

(480) 718-8860

NPI assigned

Sep 1, 2021

Last updated

Sep 1, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

1730701517As reported in NPPES

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

Authorized official

Name

Mr. Zebedee T Yong, GSP/ASHM

Title

Ceo/Facility Operations Director

Phone

(602) 521-2351

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• JEZZOB BEHAVIORAL HEALTH, LLC Doing business as

Electronic endpoints 1

Tax ID family

Jezzob Behavioral Health LLC3 organizations share this tax ID, including this one

Part of

Jezzob Behavioral Health LLC

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Jezzob Behavioral Health LLC

  • Psychiatric Residential Treatment Facility
  • Laveen, AZ
  • NPI 1730701517
  NPD tax ID
• Jezzob Behavioral Health, LLC

  • Psychiatric Residential Treatment Facility
  • Tolleson, AZ
  • NPI 1497526263
  NPD tax ID

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

{
    "created_epoch": "1630454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630454400000",
    "number": "1205504495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7409 W SOUTHGATE AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850432058",
            "telephone_number": "602-521-2351",
            "fax_number": "480-718-8860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7409 W SOUTHGATE AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850432058",
            "telephone_number": "602-521-2351",
            "fax_number": "480-718-8860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEZZOB BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "1730701517",
        "enumeration_date": "2021-09-01",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A",
        "authorized_official_last_name": "YONG",
        "authorized_official_first_name": "ZEBEDEE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CEO/FACILITY OPERATIONS DIRECTOR",
        "authorized_official_telephone_number": "602-521-2351",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "GSP/ASHM"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1981",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@jezzobhealthcare.org",
            "affiliation": "N",
            "endpointDescription": "Company e-mail",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7409 W Southgate Ave",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850432058",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "JEZZOB BEHAVIORAL HEALTH, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Psychiatric Residential Treatment Facility in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Psychiatric Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; 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.