Healthcare Provider Details

I. General information

NPI: 1114744786
Provider Name (Legal Business Name): RIGHTEOUS PATH CARE HOMES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2024
Last Update Date: 09/25/2024
Certification Date: 09/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7224 W SOPHIE LN
LAVEEN AZ
85339-3476
US

IV. Provider business mailing address

7224 W SOPHIE LN
LAVEEN AZ
85339-3476
US

V. Phone/Fax

Practice location:
  • Phone: 480-793-5485
  • Fax:
Mailing address:
  • Phone: 480-793-5485
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MARTIN REDMOND
Title or Position: OWNER
Credential:
Phone: 480-793-5485