| NPI | 1093523987 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIGUEL FERNANDO PENA Administrator 480-619-9463 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2024-12-23 |
| Last Update Date | 2024-12-23 |