NPIMap

Organization Active NPI

Big John Group Home, LLC

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Chandler, AZ
National Provider Identifier
1598812836
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
BH-1735 Issued in AZ
Legal business name
BIG JOHN GROUP HOME, LLC
Practice address
3126 N Pleasant Dr
Chandler, AZ 85225-1845
Phone
(480) 202-2972
Fax
(623) 546-0161
NPI assigned
Jan 5, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Stephanie Kay Edwards
Title
Director of Operations
Phone
(480) 202-2972

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X BH-1735 AZ Primary

Addresses

Primary practice location

3126 N Pleasant Dr
Chandler, AZ 85225-1845

Mailing address

70 S Val Vista Dr Ste A3
Gilbert, AZ 85296-1375
Phone (480) 202-2972

National Provider Directory

National Provider Directory
Tax ID family
Big John Group Home4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598812836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 S VAL VISTA DR STE A3",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852961375",
            "telephone_number": "480-202-2972",
            "fax_number": "623-546-0161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3126 N PLEASANT DR",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852251845",
            "telephone_number": "480-202-2972",
            "fax_number": "623-546-0161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIG JOHN GROUP HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "480-202-2972",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "AZ",
            "license": "BH-1735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.