NPI 1386969947

San Judas Group Home

Organisation Physical Disabilities Residential Treatment Facility Phoenix, AZ

Practice location

Address: 5116 S 11th Ave, Phoenix, AZ 85041-2363
Phone: (602) 643-5932
Fax: (602) 281-6974
Mailing address: 5415 S 5th Ave, Phoenix, AZ 85041-4000

Authorised official

Name: Imelda Melissa Noriega
Title: Administrator
Phone: (602) 643-5932

Registered specialties

Physical Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320700000X Licence ALH6076 (AZ)

Other Residential Treatment Facility, Physical Disabilities providers in Arizona →

Registry record

NPI: 1386969947
Entity type: Organization
NPI issued: 7 Apr 2010
Record last updated: 7 Apr 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.