| Ebony House Inc | |
|
1616 E Indian School Rd Ste 415 Phoenix AZ 85016-8604 | |
| (602) 281-6165 | |
| (602) 281-6522 |
| Full Name | Ebony House Inc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 1616 E Indian School Rd Ste 415, Phoenix, Arizona |
| Authorized Official Name and Position | Che Jordan (CEO) |
| Authorized Official Contact | 6022764288 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ebony House Inc 6222 S 13th St Phoenix AZ 85042-4408 Ph: (602) 276-4288 | Ebony House Inc 1616 E Indian School Rd Ste 415 Phoenix AZ 85016-8604 Ph: (602) 281-6165 |
| NPI Number | 1063073203 |
|---|---|
| Provider Enumeration Date | 06/27/2019 |
| Last Update Date | 07/26/2023 |
| Certification Date | 07/26/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063073203 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | () | Primary |
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