| NPI | 1073213062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEEON PULLEN Owner 480-227-1547 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2023-03-08 |
| Last Update Date | 2023-03-09 |