| NPI | 1164069167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYLA CHRISTINE SOL Administrator 480-232-8600 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2019-12-09 |
| Last Update Date | 2020-05-05 |