Provider Demographics
NPI:1932846714
Name:HOMEBASE ARCADIA LLC
Entity Type:Organization
Organization Name:HOMEBASE ARCADIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:OLAJUMOKE
Authorized Official - Middle Name:
Authorized Official - Last Name:IJABADENUYI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-671-6789
Mailing Address - Street 1:1839 N 39TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-3915
Mailing Address - Country:US
Mailing Address - Phone:480-440-4916
Mailing Address - Fax:
Practice Address - Street 1:1839 N 39TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-3915
Practice Address - Country:US
Practice Address - Phone:480-440-4916
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-13
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness