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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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All providers in Maricopa, AZ · Emotionally Disturbed Childrens' Residential Treatment Facility in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 13, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.