| NPI | 1215440466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEACE C EZEOGBA Director 623-633-9079 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| 323P00000X Psychiatric Residential Treatment Facility | |
| Enumeration Date | 2017-11-09 |
| Last Update Date | 2017-11-09 |