Healthcare Provider Details

I. General information

NPI: 1275472391
Provider Name (Legal Business Name): AVERRA HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2942 N 24TH ST STE 114-385
PHOENIX AZ
85016-7844
US

IV. Provider business mailing address

2942 N 24TH ST STE 114 OFFICE 21
PHOENIX AZ
85016-7849
US

V. Phone/Fax

Practice location:
  • Phone: 480-608-4764
  • Fax:
Mailing address:
  • Phone: 480-608-4764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLY NGANGA
Title or Position: OWNER
Credential:
Phone: 404-820-9690