| NPI | 1104675354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SALOMON MANIRAGUHA Co Owner 602-338-0975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2024-05-17 |
| Last Update Date | 2024-05-17 |