| NPI | 1164629333 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY YVONNE MARTINEZ Manager 602-286-0718 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: AZ ALH-5805) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2020-08-22 |