MARY GROUP HOME LLC
NPI 1760342083
Residential Treatment Facility, Emotionally Disturbed Children in Phoenix, AZ

Q: What is Mary Group Home LLC's NPI number?

The NPI number for Mary Group Home LLC is 1760342083. It was assigned to this organization in the NPPES registry on November 18, 2025.

Q: What is Mary Group Home LLC's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Emotionally Disturbed Children with taxonomy code 322D00000X.

Active since November 18, 2025

12643 N 22ND AVE, PHOENIX, AZ 85029(480) 577-7777 Get Directions Write a Review

NPPES record last updated: November 18, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mary Group Home Llc NPPES

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

MARY GROUP HOME LLC (NPI 1760342083) is a healthcare organization registered as a residential treatment facility, emotionally disturbed children in Phoenix, Arizona and active in the NPI registry since November 2025. The organization lists Abdalla Elkhalifa, Ceo, as its authorized official.

NPPES Registry Identity

NPI1760342083

Entity TypeOrganization

Primary Taxonomy322D00000X

Legal Business NameMARY GROUP HOME LLC

Location Address12643 N 22ND AVEPhoenix, AZ 85029-2652

Mailing Address12643 N 22nd AvePhoenix, AZ 85029-2652 · (480) 577-7777

Phone(480) 577-7777

Organization SubpartNo

Authorized OfficialAbdalla ElkhalifaCeo · (480) 577-7777

Enumeration DateNovember 18, 2025

NPPES CertifiedNovember 18, 2025

✔ NPI 1760342083 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyResidential Treatment Facility, Emotionally Disturbed ChildrenResidential Treatment Facilities

Taxonomy Code322D00000X

Definition

A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.

12643 N 22ND AVE, Phoenix, AZ 85029

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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

INFINITY GROUPS HOMES LLC

Clinic/Center (Adult Mental Health)

12643 N 22ND AVE
PHOENIX, AZ 85029

Maricopa County (480) 907-4474

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 Mary Group Home LLC's NPI number?

The NPI number for Mary Group Home LLC is 1760342083. It was assigned to this organization in the NPPES registry on November 18, 2025.

Where is Mary Group Home LLC located?

Mary Group Home LLC is located at 12643 N 22nd Ave, Phoenix, AZ 85029. The listed phone number is (480) 577-7777.

What is Mary Group Home LLC's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Emotionally Disturbed Children with taxonomy code 322D00000X.

When was this NPI record last updated?

The NPPES record for Mary Group Home LLC was last updated on November 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.