Healthcare Provider Details

I. General information

NPI: 1588575393
Provider Name (Legal Business Name): LEV EZRA COMMUNITY HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2625 E GREENWAY PKWY STE 256
PHOENIX AZ
85032-4369
US

IV. Provider business mailing address

19829 W BADGETT LN
LITCHFIELD PARK AZ
85340-4832
US

V. Phone/Fax

Practice location:
  • Phone: 602-473-4220
  • Fax:
Mailing address:
  • Phone: 602-473-4220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name: LACRESHA MONTOYA
Title or Position: COMMUNITY HEALTH WORKER
Credential: LICENSE/ CERTIFIED
Phone: 602-473-4220