| NPI | 1104186485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA HORNBACK Owner 623-418-6657 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2012-05-21 |