Organization
VISION GROUP HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KETURAH ANN MATTOX MBA, M.ED, M.A. (EXECUTIVE DIRECTOR/CEO)
(623) 308-5414
Entity
Organization
Contact information
Practice address
714 W SAINT KATERI DR, PHOENIX, AZ 85041-5961
(623) 308-5414
(602) 232-2196
Mailing address
714 W SAINT KATERI DR, PHOENIX, AZ 85041-5961
(623) 308-5414
(602) 232-2196
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
BH2597
AZ
Other
Enumeration date
07/20/2007
Last updated
07/20/2007
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