Healthcare Provider Details

I. General information

NPI: 1184560237
Provider Name (Legal Business Name): FAIITH GROUP HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 W IAN DR
PHOENIX AZ
85041-8120
US

IV. Provider business mailing address

2375 E CAMELBACK RD STE 600
PHOENIX AZ
85016-3493
US

V. Phone/Fax

Practice location:
  • Phone: 602-878-9299
  • Fax:
Mailing address:
  • Phone: 602-878-9299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. TERILYN SLAUGHTER
Title or Position: OWNER
Credential:
Phone: 602-878-9299