| NPI | 1043424278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUIS DANIEL PADILLA State Director 520-327-9889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: AZ 637978) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2020-08-22 |