EBONY HOUSE INC (NPI# 1063073203) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063073203 |
| Entity Type | Organization |
| Organization Name | EBONY HOUSE INC |
| Practice Address |
1616 E Indian School Rd Ste 415 Phoenix AZ 85016-8604 |
| Mailing Address |
6222 S 13th St Phoenix AZ 85042-4408 |
| Practice Telephone | 6022816165 |
| Practice Fax Number | 6022816522 |
| Mailing Telephone | 6022764288 |
| Enumeration Date | 2019-06-27 |
| Last Update Date | 2019-06-27 |
| Authorized Official Name | TONI BUGGS (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 6022764288 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144790460 | Ebony House Inc | Substance Abuse Rehabilitation Facility | 6222 S. 13th Street, Phoenix, AZ 85042 | 2018-11-29 |
| 1568937407 | Ebony House Inc | Clinic/Center | 1616 E Indian School Rd Ste 250, Phoenix, AZ 85016-8614 | 2018-10-08 |
| 1710161419 | Ebony House Inc | Counselor | 6222 S 13th St, Phoenix, AZ 85042-4408 | 2007-12-18 |
| 1851455604 | Ebony House Inc | Substance Abuse Rehabilitation Facility | 8646 S 14th St, Phoenix, AZ 85042-7902 | 2006-12-19 |
| 1023170933 | Ebony House Inc | Substance Abuse Rehabilitation Facility | 6218 S 13th St, Phoenix, AZ 85042-4408 | 2006-12-15 |
| 1518029453 | Ebony House Inc | Case Management | 1616 E Indian School Rd, Suite 100, Phoenix, AZ 85016-8601 | 2006-12-15 |
| 1114171527 | Ebony House Inc | Substance Abuse Rehabilitation Facility | 6222 S 13th St, Phoenix, AZ 85042-4408 | 2008-11-12 |
| Street Address |
1616 E INDIAN SCHOOL RD STE 415 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85016-8604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538433057 | Creative Innervisions LLC | Community Based Residential Treatment Facility, Mental Illness | 1616 E Indian School Rd Ste 415, Phoenix, AZ 85016-8604 | 2012-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992705 | Heatheranne Baker-oldfield | Counselor | 2415 E Camelback Rd Ste 700, Phoenix, AZ 85016 | 2020-11-06 |
| 1780215681 | Sip Home Systems - Mesa LLC | Home Health | 24th At Camelback, 2375 E. Camelback Rd., Suite 600, Phoenix, AZ 85016 | 2020-01-29 |
| 1760945588 | Wei Wei | Student in an Organized Health Care Education/Training Program | Phoenix Children's Hospital 1919 E. Thomas Rd., Phoenix, AZ 85016 | 2019-04-09 |
| 1942765623 | Grace Hatfield | Dietitian, Registered | Phoenix Childrens Hospital 1919 E Thomas Rd, Phoenix, AZ 85016 | 2019-02-06 |
| 1861977027 | Dawn Yvette Lima | Occupational Therapy Assistant | 3128 E Cheery Ln, Phoenix, AZ 85016 | 2018-10-03 |
| 1720583685 | Kristin Pauline Hicklin | Registered Nurse | 2930 E Camelback Rd Ste 100, Phoenix, AZ 85016 | 2018-03-24 |
| 1588181622 | Taness Eyre Billington | Pharmacist | 1625 E. Camelback Rd., Phoenix, AZ 85016 | 2017-08-29 |
| 1093239048 | Emma Ross | Psychologist | 1919 E Thomas Rd Bldg 4th, Phoenix, AZ 85016 | 2017-08-01 |
| 1609396985 | Mohammed Waseemuddin | Student in an Organized Health Care Education/Training Program | Phoenix Children's Hospital, 1919 E Thomas Rd, Phoenix, AZ 85016 | 2017-06-27 |
| 1144777632 | Amanda Mazerall | Occupational Therapist | 4333 N 24th Street, Apartment 223, Phoenix, AZ 85016 | 2016-09-01 |
| Find all providers in zip 85016 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
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|---|---|---|---|---|
| 1497372908 | A Path of Resilience - Aprbhs - Rose House - LLC | Clinic/Center | 2258 W Wayland Rd, Phoenix, AZ 85041-3753 | 2020-06-30 |
| 1083237630 | The Heart Program | Clinic/Center | 4041 E Flower St, Phoenix, AZ 85018-6433 | 2020-05-18 |
| 1316569056 | Desert Heart Counseling Corp | Clinic/Center | 1536 E Maryland Ave Ste B300, Phoenix, AZ 85014-1475 | 2020-05-16 |
| 1588212195 | Tamarria Denga | Clinic/Center | 10000 N 31st Ave Ste D411, Phoenix, AZ 85051-1358 | 2019-08-27 |
| 1043778756 | Aye Wellness, Pllc | Clinic/Center | 2406 S 24th St Ste E100, Phoenix, AZ 85034-6801 | 2019-03-12 |
| 1205391588 | Sanctuary | Clinic/Center | 2550 E Rose Garden Ln, # 73404, Phoenix, AZ 85050 | 2019-01-31 |
| 1396209474 | Enchanted Behavioral Healthcare, LLC | Clinic/Center | 11225 N 28th Dr Ste D115h, Phoenix, AZ 85029-5609 | 2019-01-23 |
| 1427548668 | Integrative Wellness Solutions, Pllc | Clinic/Center | 700 W Campbell Ave Ste 1, Phoenix, AZ 85013-2690 | 2018-05-14 |
| 1679088363 | Center for Therapy and Mindfulness | Clinic/Center | 2807 N 51st St, Phoenix, AZ 85008-1613 | 2017-12-05 |
| 1811434558 | Successful Journeys Integrated Care | Clinic/Center | 8828 N Central Ave, 206, Phoenix, AZ 85020-2849 | 2017-01-19 |
| Find all providers in PHOENIX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.