Provider Demographics
NPI:1548972417
Name:ACACIA CARE HOMES
Entity type:Organization
Organization Name:ACACIA CARE HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MAIGUA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-434-3251
Mailing Address - Street 1:45790 W STARLIGHT DR
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85139-6656
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:932 E WHITE WING DR
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-1223
Practice Address - Country:US
Practice Address - Phone:480-434-3251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACACIA CARE HOMES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-12-22
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances