| NPI | 1013608496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIGHT NGABIRE NTIMPA Administrator/Owner 602-904-0088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 261QR0800X Clinic/Center, Recovery Care |
| 251B00000X Case Management | |
| 251J00000X Nursing Care | |
| 251S00000X | |
| 261Q00000X Clinic/Center | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QP2000X Clinic/Center, Physical Therapy | |
| Enumeration Date | 2023-05-17 |
| Last Update Date | 2023-05-17 |