| NPI | 1164572616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT IAN COHEN COO 800-388-5150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: AZ 320600000X) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2023-05-14 |