Jesa Homes LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

JESA HOMES LLC

Practice address

2546 West Bloch Rd
Phoenix, AZ 85041

Phone

(480) 233-9241

Fax

(602) 276-5063

NPI assigned

May 30, 2019

Last updated

May 30, 2019By 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

Mr. Mbong Jerry NgweseNPI 1447816590

Title

Program Director

Phone

(480) 233-9241

Specialties & licenses 1

Addresses

Tax ID family

Jesa Homes LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Jesa Homes LLC

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Phoenix, AZ
  • NPI 1477843175
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mbong Jerry Ngwese

  • Sports Physical Therapist
  • Phoenix, AZ
  • NPI 1447816590
  NPD (past) Authorized official

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

{
    "created_epoch": "1559174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559174400000",
    "number": "1255999819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2328 WEST DARREL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85041",
            "telephone_number": "480-233-9241",
            "fax_number": "602-276-5063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2546 WEST BLOCH RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85041",
            "telephone_number": "480-233-9241",
            "fax_number": "602-276-5063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESA HOMES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-30",
        "last_updated": "2019-05-30",
        "status": "A",
        "authorized_official_last_name": "NGWESE",
        "authorized_official_first_name": "MBONG",
        "authorized_official_middle_name": "JERRY",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "480-233-9241",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Ellyn Jereb, DO
• Carol Jernigan, PSYD
• Hugh Warren Jernigan, D.M.D.
• Samantha Jerome, RDN, CDCES, LRD
• Tatiana Jerome, MD
• Jesa Homes LLC
• Patricia Jesse I
• Talitha Marie Jesse
• Colleen R Jessessky, RD
• Jessica Cruz Psychiatric Services, LLC

• Mental Illness Community Based Residential Treatment Facility in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Mental Illness Community Based Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2019; 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.