Ezra Group Home LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

EZRA GROUP HOME LLC

Practice address

6818 S 44TH Ave
Laveen, AZ 85339-6252

Phone

(602) 315-2058

NPI assigned

Mar 14, 2022

Last updated

Mar 14, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Zenebech Girma

Title

Administrator

Phone

(602) 315-2058

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1647216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647216000000",
    "number": "1205584695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6818 S 44TH AVE",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853396252",
            "telephone_number": "602-315-2058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6818 S 44TH AVE",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853396252",
            "telephone_number": "602-315-2058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EZRA GROUP HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-14",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A",
        "authorized_official_last_name": "GIRMA",
        "authorized_official_first_name": "ZENEBECH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "602-315-2058"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deayrie Bonita Evans, NP
• Mark Tyndal Evans, DDS
• Excellent Behavioral Health LLC
• Austin Henry Eyring, DMD
• Sharnnet Ezell
• Faith Group Angels, LLC (Faith Group Angels)
• Faithful Paths Counseling LLC (Faithful Paths)
• Family Bond Care LLC
• Family Care Behavioral Home LLC
• Famos Care

• Community/Behavioral Health Agency in Laveen, AZ
• Providers in Laveen, AZ by specialty
• Community/Behavioral Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; 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.