| NPI | 1124884184 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY KEIFALA SAMAH Administrator 623-225-2723 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2024-02-26 |
| Last Update Date | 2024-02-26 |