| NPI | 1003344367 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN KISSI LAUDER Administrator 480-516-9075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2022-07-21 |