Organization
EBENEZER BEHAVIORAL CARE, LLC
Active
Other names
Ebenezer Behavioral Care
Organization subpart
No
Provider details
NPI number
Authorized official
ROGERS K BAGIA (CEO)
(623) 806-0479
Entity
Organization
Contact information
Practice address
3141 W MALDONADO RD, PHOENIX, AZ 85041-6372
(623) 806-0479
Mailing address
3141 W MALDONADO RD, PHOENIX, AZ 85041-6372
(623) 806-0479
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
01/08/2021
Last updated
01/08/2021
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