Provider Demographics
NPI:1114699774
Name:DEBBIES HOUSE LLC
Entity Type:Organization
Organization Name:DEBBIES HOUSE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFIN PARKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-447-5640
Mailing Address - Street 1:2301 W DUNLAP AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-2845
Mailing Address - Country:US
Mailing Address - Phone:404-447-5640
Mailing Address - Fax:
Practice Address - Street 1:2301 W DUNLAP AVE STE 106
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-2845
Practice Address - Country:US
Practice Address - Phone:404-447-5640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-01
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty