| NPI | 1144917006 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELVIS WAYNE DICKSON Founder/CEO 480-984-1795 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2023-04-20 |
| Last Update Date | 2023-04-20 |