# MAE'S PLACE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Maes Place
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760233902
- **Authorized official:** LAKEYSHA DARBY (CEO)
- **Authorized official phone:** (480) 913-4882

## Contact information

- **Practice address:** 13619 W BOCA RATON RD, SURPRISE, AZ 85379
- **Practice address phone:** (480) 913-4882
- **Mailing address:** 13794 W WADDELL RD \# 203185, SURPRISE, AZ 85379-8499
- **Mailing address phone:** (148) 091-3488

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | Yes |
| 171M00000X | Case Manager/Care Coordinator | — | — | Yes |
| 172V00000X | Community Health Worker | — | NULL | — |
| 172V00000X | Community Health Worker | — | — | — |

## Other

- **Enumeration date:** 03/27/2024
- **Last updated:** 04/12/2024