Organization
P.O.W.E.R. HOUSE YOUTH FACILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GLEN ALLEN MAYBERRY M.A. ED (C.E.O.)
(480) 203-3519
Entity
Organization
Contact information
Practice address
3039 E SUPERIOR RD, QUEEN CREEK, AZ 85143-4580
(480) 458-5171
(480) 268-7167
Mailing address
PO BOX 51660, MESA, AZ 85208-0083
(480) 268-1766
(480) 268-7167
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
AZ
Other
Enumeration date
09/23/2009
Last updated
07/21/2022
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