Organization · Type 2 NPI
San Judas Group Home
Physical Disabilities Residential Treatment Facility · Phoenix, AZ
NPI number
1386969947
Active
Practice location
5116 S 11th Ave
Phoenix, AZ 85041-2363
Fax (602) 281-6974
Mailing address
5415 S 5th Ave
Phoenix, AZ 85041-4000
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physical Disabilities Residential Treatment Facility Primary | 320700000X | ALH6076 (AZ) |
Physical Disabilities Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with physical disabilities and are not able to live independently.
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About NPI 1386969947
San Judas Group Home's National Provider Identifier is 1386969947, issued on Apr 7, 2010. The primary taxonomy on file is Physical Disabilities Residential Treatment Facility (320700000X), and the practice location is in Phoenix, AZ. The record was last updated on Apr 7, 2010.