| NPI | 1134665680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN SOYARS Director 602-216-0518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: AZ BH4701) |
| Enumeration Date | 2017-01-09 |
| Last Update Date | 2023-07-28 |