# P.O.W.E.R. HOUSE YOUTH FACILITY

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

## Provider details

- **NPI number:** 1588998520
- **Authorized official:** MR. GLEN ALLEN MAYBERRY M.A. ED (C.E.O.)
- **Authorized official phone:** (480) 203-3519

## Contact information

- **Practice address:** 3039 E SUPERIOR RD, QUEEN CREEK, AZ 85143-4580
- **Practice address phone:** (480) 458-5171
- **Practice address fax:** (480) 268-7167
- **Mailing address:** PO BOX 51660, MESA, AZ 85208-0083
- **Mailing address phone:** (480) 268-1766
- **Mailing address fax:** (480) 268-7167

## Taxonomy

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

## Other

- **Enumeration date:** 09/23/2009
- **Last updated:** 07/21/2022