Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
MARY GROUP HOME LLC
Active
Organization
MARY GROUP HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABDALLA ELKHALIFA (CEO)
(480) 577-7777
Entity
Organization
Contact information
Practice address
12643 N 22ND AVE, PHOENIX, AZ 85029-2652
(480) 577-7777
Mailing address
12643 N 22ND AVE, PHOENIX, AZ 85029-2652
(480) 577-7777
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/18/2025
Last updated
11/18/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers