Mary Group Home LLC

NPI #1356964753 in Laveen, Arizona

Provider Information

NPI Number: 1356964753
Entity Type: Organization
Organization Name: Mary Group Home LLC
Primary Specialty: Community Based Residential Treatment Facility, Mental Illness
Enumeration Date: May 20, 2020
Last Updated: May 20, 2020

Practice Location

Address: 8021 S 47TH LN # 169
City: Laveen
State: Arizona
ZIP Code: 85339-2393
Phone: (480) 577-7777

Authorized Official

Name: REEM NAEUM NAEUM
Title: DIRECTOR
Phone: (623) 565-0010

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Mental Illness	320800000X	Primary

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