| NPI | 1114465978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOISES PEREZ Administrator 602-466-3223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2017-02-01 |
| Last Update Date | 2019-02-20 |