Healthcare Provider Details

I. General information

NPI: 1770121337
Provider Name (Legal Business Name): A PLACE LIKE HOME INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2019
Last Update Date: 07/25/2026
Certification Date: 07/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45646 W LONG WAY
MARICOPA AZ
85139-7070
US

IV. Provider business mailing address

45646 W LONG WAY
MARICOPA AZ
85139-7070
US

V. Phone/Fax

Practice location:
  • Phone: 773-710-8829
  • Fax: 480-470-3630
Mailing address:
  • Phone: 602-909-3934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: SHAUNTINA R MCLAURIN
Title or Position: CEO EXCUTIVE DIRECTOR
Credential:
Phone: 480-500-8462