Organization · Type 2 NPI
Mary Group Home LLC
Mental Illness Community Based Residential Treatment Facility · Laveen, AZ
NPI number
1619590478
Active
Practice location
8025 S 47th Ln
Laveen, AZ 85339-2393
Mailing address
348 S Park Grove Ln
Gilbert, AZ 85296-1731
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Illness Community Based Residential Treatment Facility Primary | 320800000X | None listed |
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 1619590478
Mary Group Home LLC's National Provider Identifier is 1619590478, issued on May 27, 2020. 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 May 27, 2020.