| NPI | 1174166136 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMGAD AWAD NASIR Manager 480-524-8649 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2019-10-22 |
| Last Update Date | 2019-10-22 |