| NPI | 1043816572 |
|---|---|
| Doing Business As | GOODYEAR HOME |
| Entity Type | Organization |
| Authorized Contact | MIREILLE MUKIZA CAO 623-792-0191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2020-12-09 |
| Last Update Date | 2020-12-09 |