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Organization
SUCCESS BEHAVIORAL GROUP HOME LLC 1
Active
Organization
SUCCESS BEHAVIORAL GROUP HOME LLC 1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EWOMAZINO JOY OMASERE (ADMINISTRATOR)
(903) 917-8122
Entity
Organization
Contact information
Practice address
9557 W AGORA LN, TOLLESON, AZ 85353-4565
(602) 558-5847
(602) 671-6752
Mailing address
9557 W AGORA LN, TOLLESON, AZ 85353-4565
(602) 558-5847
(602) 671-6752
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
—
NULL
Other
Enumeration date
11/15/2025
Last updated
11/15/2025
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