Organization
EBONY HOUSE INC
Active
Other names
Ebony House Inc
Organization subpart
No
Provider details
NPI number
Authorized official
SHEENA JONES (CEO)
(602) 276-4288
Entity
Organization
Contact information
Practice address
6222 S 13TH ST, PHOENIX, AZ 85042-4408
(602) 276-4288
(602) 232-2938
Mailing address
6222 S 13TH ST, PHOENIX, AZ 85042-4408
(602) 276-4288
(602) 232-2938
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103279
AHCCCS
AZ
Enumeration date
11/12/2008
Last updated
12/03/2025
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