| NPI | 1194214015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YSABEAU GRANDINETTI Billing Administrator 602-298-2540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2018-05-07 |
| Last Update Date | 2022-11-07 |