Individual provider · Type 1 NPI
Gwen Ellen Maddix
Child Mental Illness Respite Care · Phx, AZ
NPI number
1073680195
Active
Practice location
3436 W Malapai
Phx, AZ 85051
Mailing address
4232 W Waltann Ln
Phoenix, AZ 85053-3772
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Foster Care Agency | 253J00000X | None listed |
| Child Mental Illness Respite Care Primary | 385HR2055X | None listed |
Child Mental Illness Respite Care: A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with mental illness, as respite for the regular caregivers.
About NPI 1073680195
Gwen Ellen Maddix's National Provider Identifier is 1073680195, issued on Nov 30, 2006. The primary taxonomy on file is Child Mental Illness Respite Care (385HR2055X), and the practice location is in Phx, AZ. The record was last updated on Nov 19, 2025.