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General NPI Number Information
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NPI Number | 1639065402
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Entity Type | Organization
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Legal Business Name | MY HOUSE YOUR HOME
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Dates
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Enumeration Date | 06/17/2025
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 41277 W CIELO LN
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City | MARICOPA
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State | AZ
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Zip | 85138-3783
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Country | US
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Telephone | 480-202-0001
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Fax |
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Provider Business Mailing Address
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Address Line | 41277 W CIELO LN
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City | MARICOPA
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State | AZ
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Zip | 85138-3783
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Country | US
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Telephone | 480-202-0001
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LASHIEKA HENDERSON BIRKS
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Credential |
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Telephone | 480-202-0001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 332U00000X
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Taxonomy Name | Home Delivered Meals
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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