New Roots Residency LLC

Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Phoenix, AZ

NPI 1861024069 · NPPES record last updated Feb 6, 2020

Key facts

NPI
1861024069
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
Legal business name
NEW ROOTS RESIDENCY LLC
Practice address
3139 W Carson Rd
Phoenix, AZ 85041-6342
Phone
(480) 285-5483
Fax
(602) 675-1560
NPI assigned
Feb 6, 2020
Organization subpart
No

Authorized official

Name
Patricia Wanja Muthoni
Title
Owneradministrator
Phone
(480) 285-5483

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Yes

Addresses

Primary practice location

3139 W Carson Rd
Phoenix, AZ 85041-6342

Mailing address

3139 W Carson Rd
Phoenix, AZ 85041-6342
Phone (480) 285-5483

Other providers in Phoenix, AZ

All providers in Phoenix, AZ · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Arizona

Sources for this page

Verify at the official NPI Registry.