Organization · Type 2 NPI

Agave Residential Care Home, LLC

Mental Illness Community Based Residential Treatment Facility · Laveen, AZ

NPI number 1376058065 Active

Practice location

5628 W Glass Ln
Laveen, AZ 85339-2278

Call (602) 802-9655 Map

Specialties and licenses

TaxonomyCodeLicense
Mental Illness Community Based Residential Treatment Facility Primary 320800000XBH301 (AZ)

Mental Illness Community Based Residential Treatment Facility: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

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About NPI 1376058065

Agave Residential Care Home, LLC's National Provider Identifier is 1376058065, issued on Dec 5, 2017. The primary taxonomy on file is Mental Illness Community Based Residential Treatment Facility (320800000X), and the practice location is in Laveen, AZ. The record was last updated on Jan 22, 2026.