| NPI | 1164176145 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA KANEZA Administrator 520-270-0622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2022-02-08 |
| Last Update Date | 2022-11-01 |