| NPI | 1164067799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN O'NEAL Manager 480-388-4906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2019-11-07 |
| Last Update Date | 2020-10-27 |