Organization
BIG JOHN GROUP HOME, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STEPHANIE KAY EDWARDS (DIRECTOR OF OPERATIONS)
(480) 202-2972
Entity
Organization
Contact information
Practice address
3126 N PLEASANT DR, CHANDLER, AZ 85225-1845
(480) 202-2972
(623) 546-0161
Mailing address
70 S VAL VISTA DR STE A3, GILBERT, AZ 85296-1375
(480) 202-2972
(623) 546-0161
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
BH-1735
AZ
Other
Enumeration date
01/05/2007
Last updated
08/22/2020
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