| NPI | 1003625260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOSHE LOBL CEO 602-800-6553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2025-01-02 |
| Last Update Date | 2025-08-13 |