| NPI | 1093117384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FUNSO FEYI OGUNLA Program Director 623-374-3377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: AZ BH4488) |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2014-09-18 |