Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Darrell Lemont Ellis Jr., ADMINISTRATOR

Individual provider Emotionally Disturbed Childrens' Residential Treatment Facility · NPI 1174925424

Mr. Darrell Lemont Ellis Jr., ADMINISTRATOR is an Emotionally Disturbed Childrens' Residential Treatment Facility in Maricopa, Arizona. Practices as a sole proprietor. Licensed in Arizona.

Licensed in
AZ
In the registry since
2014

Practice location Address checks out

43646 W Yucca Ln
Maricopa, AZ 85138-2011
Phone: (520) 483-4219
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emotionally Disturbed Childrens' Residential Treatment Facility (primary) Taxonomy 322D00000X · Licence BHRF20103 (AZ)

Record details

NPI number1174925424
Entity typeIndividual (Type 1)
GenderMale
Credentials ADMINISTRATOR
Sole proprietorYes
NPI enumeratedSeptember 18, 2014
Last updated in NPPESDecember 6, 2025
Certification dateDecember 6, 2025

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