# MON AMI 2 GROUP HOME LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MON AMI 2 GROUP HOME
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255061032
- **Authorized official:** MR. SALIM OTIENO ODIERO BHT (CEO)
- **Authorized official phone:** (602) 677-6359

## Contact information

- **Practice address:** 40975 W MARY LOU DR, MARICOPA, AZ 85138-5433
- **Practice address phone:** (602) 677-6359
- **Practice address fax:** (480) 530-5408
- **Mailing address:** 40975 W MARY LOU DR, MARICOPA, AZ 85138-5433
- **Mailing address phone:** (602) 677-6359
- **Mailing address fax:** (480) 530-5408

## Taxonomy

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

## Other

- **Enumeration date:** 06/14/2022
- **Last updated:** 06/14/2022