| NPI | 1104981935 |
|---|---|
| Doing Business As | HOME AWAY FROM HOME INC |
| Entity Type | Organization |
| Authorized Contact | RICHARD AGHATISE AYIYI Administrator 602-301-0214 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: AZ bh2362 bh2361) |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2008-02-07 |