| NPI | 1245610567 |
|---|---|
| Doing Business As | ALBERT LONG RESIDENTIAL PROGRAM |
| Entity Type | Organization |
| Authorized Contact | JOHN HOGEBOOM President/CEO 480-831-7566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility (Licence: AZ BH4570) |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: AZ BH4570) | |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2023-01-02 |