Provider Demographics
NPI:1679972715
Name:EKHAYA, LLC
Entity Type:Organization
Organization Name:EKHAYA, LLC
Other - Org Name:MS EKHAYA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DARRIN
Authorized Official - Middle Name:LEON
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-858-4673
Mailing Address - Street 1:2214 25TH AVE
Mailing Address - Street 2:UNIT 1
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39501-4520
Mailing Address - Country:US
Mailing Address - Phone:504-858-4673
Mailing Address - Fax:
Practice Address - Street 1:2214 25TH AVE
Practice Address - Street 2:UNIT 101
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39501-4520
Practice Address - Country:US
Practice Address - Phone:504-858-4673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-14
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health