| NPI | 1063802205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOISE KELLY President 480-277-0313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: AZ L-1744233-1) |
| Enumeration Date | 2015-01-26 |
| Last Update Date | 2015-01-26 |