Healthcare Provider Details

I. General information

NPI: 1730049321
Provider Name (Legal Business Name): MOUNTAIN VIEW GROUP HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2025
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13445 W YOUNG ST
SURPRISE AZ
85374-5418
US

IV. Provider business mailing address

13445 W YOUNG ST
SURPRISE AZ
85374-5418
US

V. Phone/Fax

Practice location:
  • Phone: 602-554-4897
  • Fax: 602-554-4897
Mailing address:
  • Phone: 602-554-4897
  • Fax: 602-554-4897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: YELENA FRANKLIN
Title or Position: OWNER
Credential: MA, BHT
Phone: 602-554-4897