| NPI | 1174858088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEE'ANNA MARIE SMALLWOOD Chief Administion Officer 602-413-4412 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: AZ BH-3374) |
| Enumeration Date | 2009-10-09 |
| Last Update Date | 2009-10-09 |