Provider Demographics
NPI:1043907439
Name:HOME IS US LLC
Entity Type:Organization
Organization Name:HOME IS US LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEMPEBWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-964-9629
Mailing Address - Street 1:3877 N 7TH ST STE 300
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-5062
Mailing Address - Country:US
Mailing Address - Phone:818-964-9629
Mailing Address - Fax:
Practice Address - Street 1:3877 N 7TH ST STE 300
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-5062
Practice Address - Country:US
Practice Address - Phone:818-964-9629
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-18
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health