| NPI | 1073859641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIA SEIDEL Owner/Manager 602-628-3642 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: AZ AL8772H) |
| Enumeration Date | 2012-12-29 |
| Last Update Date | 2013-01-22 |