Organization
EMPIRE GROUP HOMES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMBER R. NASSER (OWNER)
(602) 430-3705
Entity
Organization
Contact information
Practice address
1629 W LACEWOOD PL, PHOENIX, AZ 85045-0814
(602) 430-3705
Mailing address
1629 W LACEWOOD PL, PHOENIX, AZ 85045-0814
(602) 430-3705
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
133N00000X
Nutritionist
—
—
133V00000X
Registered Dietitian
—
—
163W00000X
Registered Nurse
—
—
163WC0400X
Case Management Registered Nurse
—
—
163WP0808X
Psychiatric/Mental Health Registered Nurse
—
—
164W00000X
Licensed Practical Nurse
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
374U00000X
Home Health Aide
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
Other
Enumeration date
06/10/2020
Last updated
06/10/2020
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