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SAN JUDAS GROUP HOME
NPI 1386969947
Residential Treatment Facility, Physical Disabilities in Phoenix, AZ

Active since April 07, 2010
5116 S 11TH AVE, PHOENIX, AZ 85041(602) 643-5932(602) 281-6974 Get Directions Write a Review

NPPES record last updated: April 7, 2010. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About San Judas Group Home NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAN JUDAS GROUP HOME (NPI 1386969947) is a healthcare organization registered as a residential treatment facility, physical disabilities in Phoenix, Arizona and active in the NPI registry since April 2010. The organization lists Imelda Melissa Noriega, Administrator, as its authorized official.

NPPES Registry Identity

NPI1386969947
Entity TypeOrganization
Primary Taxonomy320700000X
Legal Business NameSAN JUDAS GROUP HOME
Location Address5116 S 11TH AVEPhoenix, AZ 85041-2363
Mailing Address5415 S 5th AvePhoenix, AZ 85041-4000 · (602) 643-5932 · Fax (602) 281-6974
Phone(602) 643-5932
Fax(602) 281-6974
Organization SubpartNo
Authorized OfficialImelda Melissa NoriegaAdministrator · (602) 643-5932
Enumeration DateApril 7, 2010
✔ NPI 1386969947 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyResidential Treatment Facility, Physical DisabilitiesResidential Treatment Facilities
Taxonomy Code320700000X
License✔ Licensed in AZ · ALH6076
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with physical disabilities and are not able to live independently.
5116 S 11TH AVE, Phoenix, AZ 85041
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Other Identifiers 1

Medicaid203799AZ

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is San Judas Group Home's NPI number?

The NPI number for San Judas Group Home is 1386969947. It was assigned to this organization in the NPPES registry on April 7, 2010.

Where is San Judas Group Home located?

San Judas Group Home is located at 5116 S 11th Ave, Phoenix, AZ 85041. The listed phone number is (602) 643-5932.

What is San Judas Group Home's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Physical Disabilities with taxonomy code 320700000X.

When was this NPI record last updated?

The NPPES record for San Judas Group Home was last updated on April 7, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.