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Organization
BIG JOHN GROUP HOME, LLC
Active
Organization
BIG JOHN GROUP HOME, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STEPHANIE KAY EDWARDS (DIRECTOR OF OPERATIONS)
(480) 202-2972
Entity
Organization
Contact information
Practice address
3126 N PLEASANT DR, CHANDLER, AZ 85225-1845
(480) 202-2972
(623) 546-0161
Mailing address
70 S VAL VISTA DR STE A3, GILBERT, AZ 85296-1375
(480) 202-2972
(623) 546-0161
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
BH-1735
AZ
Other
Enumeration date
01/05/2007
Last updated
08/22/2020
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