Organization
EVA HOMES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVA NISABWE (CEO/OWNER)
(520) 409-6347
Entity
Organization
Contact information
Practice address
6342 W RAYMOND ST, PHOENIX, AZ 85043-0134
(520) 332-3769
Mailing address
6342 W RAYMOND ST, PHOENIX, AZ 85043-0134
(520) 332-3769
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH7445
AZDHS
AZ
Enumeration date
03/24/2022
Last updated
03/24/2022
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