| NPI | 1235532060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARRELL LEMONT ELLIS Administrator 480-560-8924 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: AZ BH-4483) |
| Enumeration Date | 2014-10-07 |
| Last Update Date | 2014-10-07 |