| NPI | 1134747546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA FONG LEE Administrator 602-888-3037 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 103K00000X Behavior Analyst | |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
| 104100000X Social Worker | |
| 106E00000X Assistant Behavior Analyst | |
| 106S00000X Behavior Technician | |
| 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) | |
| 163WP0809X Registered Nurse, Psych/Mental Health, Adult | |
| 171M00000X Case Manager/Care Coordinator | |
| 323P00000X Psychiatric Residential Treatment Facility | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2020-07-13 |
| Last Update Date | 2020-07-13 |