# VISION GROUP HOME

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013117613
- **Authorized official:** MS. KETURAH ANN MATTOX MBA, M.ED, M.A. (EXECUTIVE DIRECTOR/CEO)
- **Authorized official phone:** (623) 308-5414

## Contact information

- **Practice address:** 714 W SAINT KATERI DR, PHOENIX, AZ 85041-5961
- **Practice address phone:** (623) 308-5414
- **Practice address fax:** (602) 232-2196
- **Mailing address:** 714 W SAINT KATERI DR, PHOENIX, AZ 85041-5961
- **Mailing address phone:** (623) 308-5414
- **Mailing address fax:** (602) 232-2196

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | BH2597 | AZ | Yes |

## Other

- **Enumeration date:** 07/20/2007
- **Last updated:** 07/20/2007