| NPI | 1073138673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IFIOK UMOREN Program Director 623-444-5989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2020-06-10 |