| NPI | 1174120703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL MUNYANKUMBURWA Administrator 520-721-1887 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| Enumeration Date | 2020-10-06 |
| Last Update Date | 2020-10-08 |