EBENEZER HOUSE, LLC
NPI 1891262556
Community Based Residential Treatment Facility, Mental Illness in Phoenix, AZ

Q: What is Ebenezer House, LLC's NPI number?

The NPI number for Ebenezer House, LLC is 1891262556. It was assigned to this organization in the NPPES registry on October 30, 2018. The provider was formerly known as Ebenezer House.

Q: What is Ebenezer House, LLC's specialty?

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

Active since October 30, 2018

4055 N 77TH DR, PHOENIX, AZ 85033(602) 686-3318 Get Directions Write a Review

NPPES record last updated: October 30, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Ebenezer House, Llc NPPES

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

EBENEZER HOUSE, LLC (NPI 1891262556), doing business as Ebenezer House, is a healthcare organization registered as a community based residential treatment facility, mental illness in Phoenix, Arizona and active in the NPI registry since October 2018. The organization lists Nigel Santiago, Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1891262556

Entity TypeOrganization

Primary Taxonomy320800000X

Legal Business NameEBENEZER HOUSE, LLC

Location Address4055 N 77TH DRPhoenix, AZ 85033-3618

Mailing Address1364 N Constellation WayGilbert, AZ 85234-1458 · (602) 686-3318

Phone(602) 686-3318

Organization SubpartNo

Authorized OfficialNigel SantiagoChief Executive Officer · (602) 686-3318

Enumeration DateOctober 30, 2018

✔ NPI 1891262556 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

Definition

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

4055 N 77TH DR, Phoenix, AZ 85033

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Other Names 1

Former Legal Business NameEbenezer House

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EBENEZER HOUSE I , LLC

Residential Treatment Facility, Intellectual and/or Developmental Disabilities

4055 N 77TH DR
PHOENIX, AZ 85033

Maricopa County (623) 440-4404

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 Ebenezer House, LLC's NPI number?

The NPI number for Ebenezer House, LLC is 1891262556. It was assigned to this organization in the NPPES registry on October 30, 2018. The provider was formerly known as Ebenezer House.

Where is Ebenezer House, LLC located?

Ebenezer House, LLC is located at 4055 N 77th Dr, Phoenix, AZ 85033. The listed phone number is (602) 686-3318.

What is Ebenezer House, 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 Ebenezer House, LLC was last updated on October 30, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years 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.