Organization
EZRA GROUP HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ZENEBECH GIRMA (ADMINISTRATOR)
(602) 315-2058
Entity
Organization
Contact information
Practice address
6818 S 44TH AVE, LAVEEN, AZ 85339-6252
(602) 315-2058
Mailing address
6818 S 44TH AVE, LAVEEN, AZ 85339-6252
(602) 315-2058
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/14/2022
Last updated
03/14/2022
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