NPIMap

Organization Active NPI

Mary Group Home LLC

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Phoenix, AZ
National Provider Identifier
1568951994
Registry record updated May 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
MARY GROUP HOME LLC
Practice address
7228 S 14TH St
Phoenix, AZ 85042-5681
Phone
(623) 565-0010
NPI assigned
May 1, 2018
Last updated
May 1, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2018

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

Authorized official

Name
Reem Naeum Naeum
Title
Owner and Ceo
Phone
(623) 565-0010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X NU Primary

Addresses

Primary practice location

7228 S 14TH St
Phoenix, AZ 85042-5681

Mailing address

7228 S 14TH St
Phoenix, AZ 85042-5681
Phone (480) 577-7777

National Provider Directory

National Provider Directory
Tax ID family
Mary Group Home LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1525132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525132800000",
    "number": "1568951994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7228 S 14TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850425681",
            "telephone_number": "480-577-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7228 S 14TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850425681",
            "telephone_number": "623-565-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY GROUP HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-01",
        "last_updated": "2018-05-01",
        "status": "A",
        "authorized_official_last_name": "NAEUM",
        "authorized_official_first_name": "REEM",
        "authorized_official_middle_name": "NAEUM",
        "authorized_official_title_or_position": "OWNER AND CEO",
        "authorized_official_telephone_number": "623-565-0010"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.