Agave Residential Care Home, Llc

LBN: Agave Residential Care Home, Llc
Agave Residential Care Home, Llc is an health care organization with primary practice located at 5628 W Glass Ln , Laveen AZ 85339-2278. The organization recently has only one registered license in Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness, which is considered as the primary health care specialty. Agave Residential Care Home, Llc can be contacted via phone (602) 802-9655, or through Ubiebor, Amanda via phone (602) 802-9655.

Contact Information

Primary practice address
5628 W Glass Ln Laveen AZ 85339-2278
Phone: (602) 802-9655
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Ubiebor, Amanda
Phone: (602) 802-9655

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness 320800000X BH301 Arizona

Profile Details

NPI number 1376058065
LBN Legal business name Agave Residential Care Home, Llc
DBA Doing business as
Authorized official Ubiebor, Amanda
Entity Organization
Organization subpart 1 No
Enumeration date Dec 5th, 2017
Last updated Aug 28th, 2021 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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