| NPI | 1073812152 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN SIAHA Director/Provider 520-272-7911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: AZ BH3831) |
| Enumeration Date | 2011-03-15 |
| Last Update Date | 2011-03-15 |