# MARY GROUP HOME LLC

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

## Provider details

- **NPI number:** 1568951994
- **Authorized official:** REEM NAEUM NAEUM (OWNER AND CEO)
- **Authorized official phone:** (623) 565-0010

## Contact information

- **Practice address:** 7228 S 14TH ST, PHOENIX, AZ 85042-5681
- **Practice address phone:** (623) 565-0010
- **Mailing address:** 7228 S 14TH ST, PHOENIX, AZ 85042-5681
- **Mailing address phone:** (480) 577-7777

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 05/01/2018
- **Last updated:** 05/01/2018