Individual provider · Type 1 NPI
Darrell Lemont Ellis Jr., ADMINISTRATOR
Emotionally Disturbed Childrens' Residential Treatment Facility · Maricopa, AZ
Practice location
43646 W Yucca Ln
Maricopa, AZ 85138-2011
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Emotionally Disturbed Childrens' Residential Treatment Facility Primary | 322D00000X | BHRF20103 (AZ) |
Emotionally Disturbed Childrens' Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.
Another provider at this address
Other emotionally disturbed childrens' residential treatment facility providers in Maricopa
About NPI 1174925424
Darrell Lemont Ellis Jr., ADMINISTRATOR's National Provider Identifier is 1174925424, issued on Sep 18, 2014. The primary taxonomy on file is Emotionally Disturbed Childrens' Residential Treatment Facility (322D00000X), and the practice location is in Maricopa, AZ. The record was last updated on Dec 6, 2025.