Organization · Type 2 NPI
Mary Group Home LLC
Emotionally Disturbed Childrens' Residential Treatment Facility · Phoenix, AZ
NPI number
1760342083
Active
Practice location
12643 N 22nd Ave
Phoenix, AZ 85029-2652
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Emotionally Disturbed Childrens' Residential Treatment Facility Primary | 322D00000X | None listed |
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.
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About NPI 1760342083
Mary Group Home LLC's National Provider Identifier is 1760342083, issued on Nov 18, 2025. The primary taxonomy on file is Emotionally Disturbed Childrens' Residential Treatment Facility (322D00000X), and the practice location is in Phoenix, AZ. The record was last updated on Nov 18, 2025.