| NPI | 1003244153 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN PAUL MILLS Claims Supervisor 602-263-5242 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: AZ BH-2209) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: AZ BH-2209) |
| Enumeration Date | 2013-10-29 |
| Last Update Date | 2023-12-27 |