| NPI | 1144734625 |
|---|---|
| Doing Business As | BROAD BEACH RETREAT |
| Entity Type | Organization |
| Authorized Contact | EDWARD DONAHUE CFO And Authorized Official 928-668-4232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2017-11-20 |
| Last Update Date | 2018-10-04 |