NPI | 1184206369 |
---|---|
Entity Type | Organization |
Authorized Contact | KYONA JESSELL RELF Owner 480-930-3646 |
Organization Subpart ? | No |
Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
Enumeration Date | 2021-04-27 |
Last Update Date | 2021-04-27 |