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

Ebenezer House I , LLC

Organization Intellectual and/or Developmental Disabilities Residential Treatment Facility · NPI 1407426273

Ebenezer House I , LLC is an Intellectual and/or Developmental Disabilities Residential Treatment Facility in Phoenix, Arizona. Registered with an NPI since 2021.

In the registry since
2021
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

4055 N 77th Dr
Phoenix, AZ 85033-3618
Phone: (623) 440-4404
Fax: (623) 777-0082
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Intellectual and/or Developmental Disabilities Residential Treatment Facility (primary) Taxonomy 320600000X

Record details

NPI number1407426273
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Eric Nibizi — Ceo · (623) 440-4404
Other names Ebenezer House I
NPI enumeratedJune 24, 2021
Last updated in NPPESJune 24, 2021
Certification dateJune 24, 2021
Mailing address11114 W College Dr, Phoenix, AZ 85037-1269

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