NPI | 1164169256 |
---|---|
Entity Type | Organization |
Authorized Contact | SHANTE M MCLENDON Owner 623-666-3673 |
Organization Subpart ? | No |
Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
171M00000X Case Manager/Care Coordinator | |
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
Enumeration Date | 2022-05-19 |
Last Update Date | 2025-10-03 |