Provider Demographics
NPI:1760358980
Name:ZEN RECOVERY AT HOME LLC
Entity type:Organization
Organization Name:ZEN RECOVERY AT HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:EBONY
Authorized Official - Middle Name:CHERISE
Authorized Official - Last Name:BRUSHBREAKER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:702-427-4537
Mailing Address - Street 1:7040 W WINSTON DR
Mailing Address - Street 2:
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339-5518
Mailing Address - Country:US
Mailing Address - Phone:792-427-4537
Mailing Address - Fax:
Practice Address - Street 1:7040 W WINSTON DR
Practice Address - Street 2:
Practice Address - City:LAVEEN
Practice Address - State:AZ
Practice Address - Zip Code:85339-5518
Practice Address - Country:US
Practice Address - Phone:792-427-4537
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-14
Last Update Date:2025-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty