| NPI | 1053750760 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW LUCHINI Account Manager 928-533-4220 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2013-06-17 |