Park Grove LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

PARK GROVE LLC

Practice address

348 S Park Grove LN
Gilbert, AZ 85296-1731

Phone

(623) 565-0010

Fax

(623) 565-0010

NPI assigned

Jan 2, 2018

Organization subpart

No

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

Authorized official

Name

Reem Naeum

Title

Owner

Phone

(623) 565-0010

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1514851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514851200000",
    "number": "1477060341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "348 S PARK GROVE LN",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852961731",
            "telephone_number": "623-565-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 S PARK GROVE LN",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852961731",
            "telephone_number": "623-565-0010",
            "fax_number": "623-565-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK GROVE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-02",
        "last_updated": "2018-01-02",
        "status": "A",
        "authorized_official_last_name": "NAEUM",
        "authorized_official_first_name": "REEM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-565-0010"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Pantoja
• Nathan Papadeas, PA-C
• Ann Papagalos
• Carmen Pappalardo
• Matthew Parisek
• Heesun Stephanie Park
• Patricia Kay Park, FNP, DNP
• Soyoung Park, MD
• Tammy Park, DNP, CNM
• Carlyn A Parker, MS

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2018; 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.