| NPI | 1063578730 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INDRA DAYANA GARCIA CHAVEZ Administrative Services Manager 602-285-0505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: AZ BH1181) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2025-09-02 |