Dharma Residential Az LLC

Organization Active NPI Emotionally Disturbed Childrens' Residential Treatment Facility · Maricopa, AZ

NPI 1609667476 · NPPES record last updated May 13, 2025

Key facts

NPI
1609667476
Entity type
Organization (NPI type 2)
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X
Legal business name
DHARMA RESIDENTIAL AZ LLC
Practice address
19118 N San Juan St
Maricopa, AZ 85138-2532
Phone
(314) 494-7603
NPI assigned
May 13, 2025
Organization subpart
No

Authorized official

Name
Cermillia Williams, MSW,MBA
Title
Ceo
Phone
(314) 494-7603

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
Physical Disabilities Residential Treatment Facility 320700000X
Mental Illness Community Based Residential Treatment Facility 320800000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X Yes
Psychiatric Residential Treatment Facility 323P00000X

Addresses

Primary practice location

19118 N San Juan St
Maricopa, AZ 85138-2532

Mailing address

19118 N San Juan St
Maricopa, AZ 85138-2532
Phone (314) 494-7603

Other providers in Maricopa, AZ

All providers in Maricopa, AZ · Emotionally Disturbed Childrens' Residential Treatment Facility in Arizona

Sources for this page

Verify at the official NPI Registry.