# BIG JOHN GROUP HOME

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

## Provider details

- **NPI number:** 1528111622
- **Authorized official:** MRS. STEPHANIE KAY EDWARDS (DIRECTOR OF OPERATIONS)
- **Authorized official phone:** (480) 202-2972

## Contact information

- **Practice address:** 1540 E WHITTEN ST, CHANDLER, AZ 85225-2215
- **Practice address phone:** (480) 202-2972
- **Practice address fax:** (623) 546-0161
- **Mailing address:** 70 S VAL VISTA DR STE A3 \# 488, GILBERT, AZ 85296-1375
- **Mailing address phone:** (480) 202-2972
- **Mailing address fax:** (623) 546-0161

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | 723644 | AZ | Yes |

## Other

- **Enumeration date:** 01/19/2007
- **Last updated:** 08/22/2020