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General NPI Number Information
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NPI Number | 1114171527
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Entity Type | Organization
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Legal Business Name | EBONY HOUSE INC
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Dates
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Enumeration Date | 11/12/2008
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 6222 S 13TH ST
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City | PHOENIX
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State | AZ
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Zip | 85042-4408
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Country | US
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Telephone | 602-276-4288
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Fax | 602-232-2938
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Provider Business Mailing Address
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Address Line | 6222 S 13TH ST
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City | PHOENIX
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State | AZ
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Zip | 85042-4408
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Country | US
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Telephone | 602-276-4288
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Fax | 602-232-2938
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Authorized Official
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Title or Position | CEO
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Name | SHEENA JONES
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Credential |
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Telephone | 602-276-4288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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