| NPI | 1003283417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOY TALABI Administrator 480-603-5286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: AZ BH4563) |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: AZ BH4563) |
| 323P00000X Psychiatric Residential Treatment Facility (Licence: AZ BH4563) | |
| Enumeration Date | 2015-09-02 |
| Last Update Date | 2015-09-02 |