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, Mental Retardation and/or Developmental Disabilities (Licence: AZ BH2362 BH2361) |
Enumeration Date | 2006-12-22 |
Last Update Date | 2008-02-07 |