Healthcare Provider Details

I. General information

NPI: 1548189798
Provider Name (Legal Business Name): MAYA THERAPY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12914 W SIERRA VISTA DR
GLENDALE AZ
85307-1915
US

IV. Provider business mailing address

505 S MADISON DR
TEMPE AZ
85281-7213
US

V. Phone/Fax

Practice location:
  • Phone: 602-322-7038
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: JASMINE ROBINSON
Title or Position: OWNER
Credential:
Phone: 216-832-0356