| NPI | 1033460985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOISES PEREZ Administrator 602-466-3223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: AZ BH4095) |
| Enumeration Date | 2012-10-01 |
| Last Update Date | 2012-10-01 |