AGAVE RESIDENTIAL CARE HOME, LLC
NPI 1376058065
Community Based Residential Treatment Facility, Mental Illness in Laveen, AZ

Q: What is Agave Residential Care Home, LLC's NPI number?

The NPI number for Agave Residential Care Home, LLC is 1376058065. It was assigned to this organization in the NPPES registry on December 5, 2017.

Q: What is Agave Residential Care Home, LLC's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Mental Illness with taxonomy code 320800000X.

Active since December 05, 2017

5628 W GLASS LN, LAVEEN, AZ 85339(602) 802-9655 Get Directions Write a Review

NPPES record last updated: January 22, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 22, 2026, Aug 28, 2021, Dec 5, 2017 (3 updates tracked since 2017).

On this page

About Agave Residential Care Home, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AGAVE RESIDENTIAL CARE HOME, LLC (NPI 1376058065) is a healthcare organization registered as a community based residential treatment facility, mental illness in Laveen, Arizona and active in the NPI registry since December 2017. The organization lists Festus Ubiebor, Cheif Officer, as its authorized official.

NPPES Registry Identity

NPI1376058065

Entity TypeOrganization

Primary Taxonomy320800000X

Legal Business NameAGAVE RESIDENTIAL CARE HOME, LLC

Location Address5628 W GLASS LNLaveen, AZ 85339-2278

Mailing Address5628 W Glass LnLaveen, AZ 85339-2278 · (602) 802-9655

Phone(602) 802-9655

Organization SubpartNo

Authorized OfficialFestus UbieborCheif Officer · (602) 931-7437

Enumeration DateDecember 5, 2017

Last NPPES UpdateJanuary 22, 20263 updates tracked since enumeration

NPPES CertifiedJanuary 22, 2026

✔ NPI 1376058065 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Mental IllnessResidential Treatment Facilities

Taxonomy Code320800000X

License✔ Licensed in AZ · BH301

Definition

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

5628 W GLASS LN, Laveen, AZ 85339

Open in Google Maps ↗

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Agave Residential Care Home, LLC's NPI number?

The NPI number for Agave Residential Care Home, LLC is 1376058065. It was assigned to this organization in the NPPES registry on December 5, 2017.

Where is Agave Residential Care Home, LLC located?

Agave Residential Care Home, LLC is located at 5628 W Glass Ln, Laveen, AZ 85339. The listed phone number is (602) 802-9655.

What is Agave Residential Care Home, LLC's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Mental Illness with taxonomy code 320800000X.

When was this NPI record last updated?

The NPPES record for Agave Residential Care Home, LLC was last updated on January 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.