PA-Vee Group Home LLC

Primary specialty

Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X

Legal business name

PA-VEE GROUP HOME LLC

Practice address

7909 S 41St Dr
Laveen, AZ 85339-2543

Phone

(602) 675-1130

Fax

(602) 314-5740

NPI assigned

Jan 23, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jango Massalay

Title

Director

Phone

(602) 675-1130

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674432000000",
    "number": "1245945377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7909 S 41ST DR",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853392543",
            "telephone_number": "602-675-1130",
            "fax_number": "602-314-5740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7909 S 41ST DR",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853392543",
            "telephone_number": "602-675-1130",
            "fax_number": "602-314-5740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PA-VEE GROUP HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-23",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A",
        "authorized_official_last_name": "MASSALAY",
        "authorized_official_first_name": "JANGO",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "602-675-1130"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric Residential Treatment Facility in Laveen, AZ
• Providers in Laveen, AZ by specialty
• Psychiatric Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.