| NPI | 1194087031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLUGBENGA A TEPEDE Program Administrator 623-363-6408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: AZ BH4024) |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2012-06-15 |