Provider Demographics
NPI:1538816822
Name:ACADIA CARE GROUP LLC
Entity type:Organization
Organization Name:ACADIA CARE GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-401-1200
Mailing Address - Street 1:3577 E TREMAINE AVE
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-5282
Mailing Address - Country:US
Mailing Address - Phone:602-826-1400
Mailing Address - Fax:602-401-1300
Practice Address - Street 1:1166 E WARNER RD STE 119
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-3065
Practice Address - Country:US
Practice Address - Phone:480-401-1200
Practice Address - Fax:480-401-1300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-07
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ111362Medicaid