NPIMap

Organization Active NPI

Jesa Homes LLC

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Phoenix, AZ
National Provider Identifier
1477843175
Registry record updated Apr 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
BH3810 Issued in AZ
Legal business name
JESA HOMES LLC
Practice address
2328 W Darrel Rd
Phoenix, AZ 85041-6412
Phone
(602) 268-1767
Fax
(602) 268-1277
NPI assigned
Apr 14, 2011
Last updated
Apr 14, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2011

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
Co-Owner
Phone
(480) 233-9241

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X BH3810 AZ Primary

Addresses

Primary practice location

2328 W Darrel Rd
Phoenix, AZ 85041-6412

Mailing address

2328 W Darrel Rd
Phoenix, AZ 85041-6412
Phone (602) 268-1767

National Provider Directory

National Provider Directory
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.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1302739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302739200000",
    "number": "1477843175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2328 W DARREL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850416412",
            "telephone_number": "602-268-1767",
            "fax_number": "602-268-1277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2328 W DARREL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850416412",
            "telephone_number": "602-268-1767",
            "fax_number": "602-268-1277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESA HOMES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-14",
        "last_updated": "2011-04-14",
        "status": "A",
        "authorized_official_last_name": "NGWESE",
        "authorized_official_first_name": "MBONG",
        "authorized_official_middle_name": "JERRY",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "480-233-9241",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "AZ",
            "license": "BH3810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2011; 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.