# DHARMA RESIDENTIAL AZ LLC

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

## Provider details

- **NPI number:** 1609667476
- **Authorized official:** CERMILLIA WILLIAMS MSW,MBA (CEO)
- **Authorized official phone:** (314) 494-7603

## Contact information

- **Practice address:** 19118 N SAN JUAN ST, MARICOPA, AZ 85138-2532
- **Practice address phone:** (314) 494-7603
- **Mailing address:** 19118 N SAN JUAN ST, MARICOPA, AZ 85138-2532
- **Mailing address phone:** (314) 494-7603

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | — | — |
| 320700000X | Physical Disabilities Residential Treatment Facility | — | — | — |
| 320800000X | Mental Illness Community Based Residential Treatment Facility | — | — | — |
| 320900000X | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | — | — | — |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | — | Yes |
| 323P00000X | Psychiatric Residential Treatment Facility | — | — | — |

## Other

- **Enumeration date:** 05/13/2025
- **Last updated:** 05/13/2025