| NPI | 1194164525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW LUCHINI Account Manager 928-533-4220 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2013-06-19 |