Provider Demographics
NPI:1023517315
Name:HABONA SERVICES
Entity type:Organization
Organization Name:HABONA SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NKONYE
Authorized Official - Middle Name:
Authorized Official - Last Name:EZEOBAH
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C, RNC-MNN, EDD
Authorized Official - Phone:310-972-8843
Mailing Address - Street 1:PO BOX 2501
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90247-0501
Mailing Address - Country:US
Mailing Address - Phone:310-972-8843
Mailing Address - Fax:
Practice Address - Street 1:4405 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90037-2731
Practice Address - Country:US
Practice Address - Phone:323-231-0659
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-02
Last Update Date:2018-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical