| NPI | 1104455534 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN SALEM Admin 480-476-8912 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2020-04-07 |
| Last Update Date | 2025-04-30 |