| NPI | 1134622103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATARRIE MARTIN CEO 602-561-5601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 385HR2050X Respite Care, Respite Care Camp |
| 385HR2055X Respite Care, Respite Care, Mental Illness, Child | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| 251B00000X Case Management | |
| 251E00000X Home Health | |
| 251K00000X Public Health or Welfare | |
| 251S00000X | |
| 252Y00000X Early Intervention Provider Agency | |
| 253Z00000X In Home Supportive Care | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2018-03-15 |
| Last Update Date | 2020-07-02 |