| NPI | 1003555400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD FRANCIS GATHUNGU Administrator 602-413-5177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2022-06-02 |
| Last Update Date | 2022-06-02 |