Organization
EBENEZER HOUSE 1LLC
Active
Other names
EBENEZER HOUSE
Organization subpart
No
Provider details
NPI number
Authorized official
OSSIE TORGRIMSON (CHIEF OFFICER FINANICAL)
(407) 236-6552
Entity
Organization
Contact information
Practice address
35168 N MAGNETTE WAY, QUEEN CREEK, AZ 85142-3916
(407) 236-6552
Mailing address
35168 N MAGNETTE WAY, QUEEN CREEK, AZ 85142-3916
(407) 236-6552
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
06/15/2022
Last updated
06/15/2022
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