Healthcare Provider Details

I. General information

NPI: 1346553484
Provider Name (Legal Business Name): UNITY GROUP HOMES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2010
Last Update Date: 07/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

744 W 6TH AVE
MESA AZ
85210-2312
US

IV. Provider business mailing address

70 S VAL VISTA DR SUITE A3
GILBERT AZ
85296-1374
US

V. Phone/Fax

Practice location:
  • Phone: 480-202-2972
  • Fax: 623-546-0161
Mailing address:
  • Phone: 480-202-2972
  • Fax: 623-546-0161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberAL7524H
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code3104A0630X
TaxonomyAssisted Living Facility (Behavioral Disturbances)
License NumberAL7524H
License Number StateAZ

VIII. Authorized Official

Name: MRS. STEPHANIE KAY EDWARDS
Title or Position: OWNER
Credential:
Phone: 480-202-2972