| NPI | 1205307220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA PROCHUT Credentialing Specialist 480-619-8556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2018-12-17 |