Provider Demographics
NPI:1235708181
Name:AZION HOMES LLC
Entity Type:Organization
Organization Name:AZION HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NJOROGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-486-7198
Mailing Address - Street 1:3522 LIBERTY SQUARE TRL
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:TX
Mailing Address - Zip Code:77545-8822
Mailing Address - Country:US
Mailing Address - Phone:832-486-7198
Mailing Address - Fax:
Practice Address - Street 1:3522 LIBERTY SQUARE TRL
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:TX
Practice Address - Zip Code:77545-8822
Practice Address - Country:US
Practice Address - Phone:832-486-7198
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-23
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities