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Organization

MY HOUSE YOUR HOME

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LASHIEKA HENDERSON BIRKS (CEO)
(480) 202-0001
Entity
Organization

Contact information

Practice address
41277 W CIELO LN, MARICOPA, AZ 85138-3783
(480) 202-0001
Mailing address
41277 W CIELO LN, MARICOPA, AZ 85138-3783
(480) 202-0001

Taxonomy

Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
311Z00000X
Custodial Care Facility
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
332U00000X
Home Delivered Meals
347C00000X
Private Vehicle
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care

Other

Enumeration date
06/17/2025
Last updated
06/17/2025
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