Provider Demographics
NPI:1457034761
Name:HOWELL GROUP HOME LLC
Entity Type:Organization
Organization Name:HOWELL GROUP HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:
Authorized Official - Last Name:MALVEAUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-382-1175
Mailing Address - Street 1:46101 W MOUNTAIN VIEW RD
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85139-6797
Mailing Address - Country:US
Mailing Address - Phone:480-331-5753
Mailing Address - Fax:
Practice Address - Street 1:46101 W MOUNTAIN VIEW RD
Practice Address - Street 2:
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85139-6797
Practice Address - Country:US
Practice Address - Phone:480-331-5753
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-11
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services