| NPI | 1225743347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHRYN MARIE SANDOVAL Owner / Operator 928-699-4203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 174200000X Meals |
| 251B00000X Case Management | |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 251E00000X Home Health | |
| 251K00000X Public Health or Welfare | |
| 251T00000X PACE Provider Organization | |
| 253Z00000X In Home Supportive Care | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 405300000X Prevention Professional | |
| Enumeration Date | 2023-01-23 |
| Last Update Date | 2023-01-25 |