Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Agave Residential Care Home, LLC

Organization Mental Illness Community Based Residential Treatment Facility · NPI 1376058065

Agave Residential Care Home, LLC is a Mental Illness Community Based Residential Treatment Facility in Laveen, Arizona. Licensed in Arizona. Registered with an NPI since 2017.

Licensed in
AZ
In the registry since
2017
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5628 W Glass Ln
Laveen, AZ 85339-2278
Phone: (602) 802-9655
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Illness Community Based Residential Treatment Facility (primary) Taxonomy 320800000X · Licence BH301 (AZ)

Record details

NPI number1376058065
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Festus Ubiebor — Cheif Officer · (602) 931-7437
NPI enumeratedDecember 5, 2017
Last updated in NPPESJanuary 22, 2026
Certification dateJanuary 22, 2026
Mailing address5628 W Glass Ln, Laveen, AZ 85339-2278

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