| NPI | 1053965376 |
|---|---|
| Doing Business As | A LIVING ROOM ON BROADWAY |
| Entity Type | Organization |
| Authorized Contact | CYNTHIA MILLER-POTTER Employee 520-954-5454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2019-07-25 |
| Last Update Date | 2019-10-18 |