| NPI | 1003049487 |
|---|---|
| Doing Business As | ARIZONA MENTOR- EVERGREEN |
| Entity Type | Organization |
| Authorized Contact | BRETT IAN COHEN COO 800-388-5150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: AZ BH-3412) |
| Enumeration Date | 2009-09-01 |
| Last Update Date | 2023-05-14 |