Provider Demographics
NPI:1407502727
Name:WEMA HOMES LLC
Entity Type:Organization
Organization Name:WEMA HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HOUSE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:EYVON
Authorized Official - Middle Name:G
Authorized Official - Last Name:KANYUA
Authorized Official - Suffix:
Authorized Official - Credentials:ADIMINISTER
Authorized Official - Phone:480-324-6999
Mailing Address - Street 1:1133 E HEATHER DR
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85140-5678
Mailing Address - Country:US
Mailing Address - Phone:480-324-6999
Mailing Address - Fax:
Practice Address - Street 1:1133 E HEATHER DR
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85140-5678
Practice Address - Country:US
Practice Address - Phone:480-324-6999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No174200000XOther Service ProvidersMeals
No253Z00000XAgenciesIn Home Supportive Care
No276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1407502727Medicaid